The Impact of a Graduation
Program on Child
Development in Refugee and
Host Communities in Uganda
Technical and Operational Performance Support
(TOPS) Uganda Graduation Randomized Control Trial
Associate Award
March 2023
The Technical and Operational Performance Support (TOPS) Uganda Graduation Randomized
Control Trial (RCT) Associate Award works to measure the cost‐effectiveness of different
variations of graduation programming for refugees and host communities in Uganda, as part of
the United States Agency for International Development (USAID) Bureau for a Humanitarian
Assistance (BHA)-funded Pilot resilience food security activity (RFSA) there. This information will
help the food security community of practice and USAID to design projects and modify existing
projects in ways that bolster performance, efficiency, and effectiveness. The TOPS Uganda
Graduation RCT Associate Award is a seven-year activity (2017–2023) implemented by Save the
Children (lead) and Innovations for Poverty Action.
Disclaimer:
This report is made possible by the generous support of the American people through the
United States Agency for International Development (USAID). The contents are the responsibility
of the Technical and Operational Performance Support (TOPS) Uganda Graduation Randomized
Control Trial (RCT) Associate Award and do not necessarily reflect the views of USAID or the
United States Government.
Photo Credit:
Innovations for Poverty Action.
Recommended Citation:
Technical and Operational Performance Support (TOPS) Uganda Graduation Randomized Control
Trial Associate Award. 2022. The Impact of a Graduation Program on child development in
Refugee and Host Communities in Uganda. Washington, DC: The TOPS Program.
Contact:
Save the Children
899 North Capitol St NE, Suite 900
Washington, DC 20002
IMPEL@savechildren.org
www.fsnnetwork.org
Prepared By:
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Contents
i
Contents
List of Tables......................................................................................................................................ii
Abbreviations and Acronyms.............................................................................................................iii
Acknowledgments ............................................................................................................................iv
Executive Summary............................................................................................................................ v
1. Context..................................................................................................................................1
Graduation to Resilience..................................................................................................... 1
1.1. Child Development Follow-Up ............................................................................................ 2
2. Methodology .........................................................................................................................3
2.1. Randomization.................................................................................................................... 3
2.2. Empirical Strategy ............................................................................................................... 3
2.3. Analysis............................................................................................................................... 3
3. Study Sample.........................................................................................................................4
4. Data Collection ......................................................................................................................5
4.1. Questionnaire ..................................................................................................................... 5
4.2. Outcomes Measured .......................................................................................................... 6
4.2.1. Primary Outcome................................................................................................... 6
4.2.2. Secondary Outcome .............................................................................................. 6
4.3. Attrition............................................................................................................................... 6
5. Sample Characteristics...........................................................................................................8
6. Results...................................................................................................................................9
6.1. Impact of the Program........................................................................................................ 9
7. References...........................................................................................................................11
Annex A: Treatment Effect, Unadjusted Models................................................................................12
Annex B: Treatment Effect Estimates, by Community........................................................................13
Annex C: Balance Test......................................................................................................................16
Annex D: Pre-Analysis Plan...............................................................................................................17
Annex E: Study Instrument...............................................................................................................19
TOPS Uganda Graduation RCT Associate Award
List of Tables
ii
List of Tables
Table 1. Number of households and villages, by community.......................................................................4
Table 2. Response rate per community and arm..........................................................................................5
Table 3. Number of households not surveyed, by community.....................................................................6
Table 4. Reasons for not being surveyed, by community.............................................................................7
Table 5. Attrition across experimental groups and community ...................................................................7
Table 6. Demographics..................................................................................................................................8
Table 7. Child Health.....................................................................................................................................8
Table 8. Impact of the program BSID, adjusted............................................................................................9
Table 9. Impact of the program CREDI, adjusted........................................................................................10
Table 10. Impact of the program BSID, unadjusted....................................................................................12
Table 11. Impact of the program CREDI, unadjusted .................................................................................12
Table 12. Impact of the program BSID unadjusted, refugee ......................................................................13
Table 13. Impact of the program BSID adjusted, refugee ..........................................................................13
Table 14. Impact of the program CREDI unadjusted, refugee ....................................................................14
Table 15. Impact of the program CREDI adjusted, refugee ........................................................................14
Table 16. Impact of the program BSID unadjusted, host............................................................................14
Table 17. Impact of the program BSID adjusted, host................................................................................15
Table 18. Impact of the program CREDI unadjusted, host .........................................................................15
Table 19. Impact of the program CREDI adjusted, host..............................................................................15
Table 20. Balance test.................................................................................................................................16
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Abbreviations and Acronyms
iii
Abbreviations and Acronyms
BSID Bayley Scales of Infant and Toddler Development
BSID-III Bayley Scales for Infant and Toddler Development Version III
C1 Control Arm 1 (Spillover Control, "Control in Treatment Villages")
CREDI Caregiver Reported Early Development Instruments
ECD Early Childhood Development
DFSA Development Food Security Activity
HAZ Height-for-Age z-score
HDDS Household Dietary Diversity Score
IPA Innovations for Poverty Action
RCT Randomized Control Trial
RFSA Resilience Food Security Activity
T1 Treatment Arm 1 (Individual, Asset)
T2 Treatment Arm 2 (Group, Asset)
T3 Treatment Arm 3 (Individual, No Asset)
TOPS Technical and Operational Performance Support
USAID United States Agency for International Development
WAZ Weight-for-Age z-score
WHZ Weight-for-Height z-score
TOPS Uganda Graduation RCT Associate Award
Acknowledgments
iv
Acknowledgments
This report was written by Monserrat Lara, Antoine Guilhin, Julie Kedroske, Jan Will, and Doug
Parkerson from Innovations for Poverty Action, and Peter Rockers from Boston University. The
data collection was supervised by Allan Claudio Katimbo Katurebe from Innovations for Poverty
Action.
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Executive Summary
v
Executive Summary
The United States Agency for International Development (USAID) awarded the implementation
of a resilience food security activity (RFSA) in Kamwenge District, Uganda, to the AVSI
Foundation (AVSI).
The Graduating to Resilience RFSA aimed to improve food security, nutrition, self-reliance, and
resilience among extremely poor refugee and host households in Rwamwanja Refugee
Settlement and the surrounding host community of Kamwenge District. The graduation
approach is a multifaceted model composed of various activities: namely livelihood promotion,
financial inclusion, social empowerment, and social protection components.
The Graduating to Resilience activity produced large, positive impacts in Cohort 1 on householdlevel measures of assets, consumption, income, and food security. These results also showed
important improvements in nutrition, including dietary diversity and breastfeeding, however
they did not immediately translate to measurable impacts on anthropometric child indicators.
While the Graduating to Resilience activity was not explicitly designed to influence child
development, an observed reduction in poverty could positively impact developmental
outcomes.
This study is an intervention trial that aims to estimate the impact of the Graduating to
Resilience activity on child development in Uganda. We revisited a sample of households
enrolled in the Graduating to Resilience trial conducted in Uganda in 2019–2021 and assessed
children born during the intervention.
The target sample was composed of 1,688 households residing in 57 study villages. Eligibility for
our sample was restricted to households enrolled in Arm 1, Arm 2, and Spillover Control. We
used two instruments to measure child development: Bayley Scales of Infant and Toddler
Development (BSID) and Caregiver Reported Early Development Instruments (CREDI).
Between September 14 and November 9, 2022, Innovations for Poverty Action (IPA) conducted
a follow-up survey and interviewed 1,503 caregiver-child dyads, 507 dyads from Arm 1, 520
from Arm 2, and 476 from Spillover Control.
We find that the Graduating to Resilience activity had no impact on children’s cognitive, motor,
language, or social-emotional development, measured by the BSID. We found similar null results
for the same domains measured by the CREDI.
This page is left intentionally blank.
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Context
1
1. Context
Graduation to Resilience
In 2017, the United States Agency for International Development (USAID) awarded the AVSI
Foundation the implementation of a resilience food security activity (RFSA)1 in Kamwenge
District, Uganda.
As part of the RFSA, AVSI was tasked with adapting a graduation program to improve food
security, nutrition, self-reliance, and resilience among extremely poor refugee and host
households in Rwamwanja Refugee Settlement and the surrounding host community of
Kamwenge District.
The graduation approach combines livelihood promotion, financial inclusion, social
empowerment, and social protection components. It is designed to address extremely poor
households' needs and equip recipients with protection processes, such as sustainable
livelihoods and improved savings and household dynamics, by building skills and confidence. The
initiative seeks to ensure households can meet their basic needs and build an asset base to
diversify income, protect themselves from shocks, and sustain wellbeing. The approach typically
consists of six components:
1. Consumption support: to stabilize incomes and enable households to focus on skills
training to build or expand livelihoods and prevent consumption of productive
assets.
2. Productive asset transfer: in-kind (for instance, livestock) or cash for any small-scale
income-generating activity.
3. Technical training: covering improved agronomic and animal husbandry technical
skills, financial literacy, enterprise selection planning and management, climate risk
management, and bank linkages.
4. Coaching: to build a relationship between a coach and participant through regular
visits and support sessions (generally weekly, bi-weekly, or monthly) over 30
months to help households set realistic goals and solve problems as they arise,
reinforce key lessons, link/refer participants to needed services, and monitor
households’ progress.
5. Access to savings: to create a secure place to save resources and access financial
capital to grow businesses and meet current and future household needs.
6. Referrals and linkages to critical health services: basic information on sanitation and
nutrition, nutrition referral and management support, public and private sector
extension services, group registration, financial services, and access to inputs.
1 Originally named a development food security activity (DFSA).
TOPS Uganda Graduation RCT Associate Award
Context
2
1.1. Child Development Follow-Up
Graduating to Resilience produced large, positive impacts in Cohort 1 on household-level
measures of assets, consumption, income, and food security. These results also showed
important improvements in nutrition as well, however they did not immediately translate to
measurable impacts on anthropometric measures of child growth (height-for-age z-score (HAZ),
weight-for-length/height z-score (WHZ), or weight-for-age z-score (WAZ)). Despite this, we
hypothesize that the observed reduction in poverty in beneficiary households generated
significant positive impacts on broader measures of child development.
Early exposure to poverty and related adverse experiences, including toxic stress, malnutrition,
and psychosocial deprivation, impedes child brain development and skill formation (Johnson et
al., 2016, Nelson et al., 2020).2 A large body of evidence shows that the negative effects of
poverty-related adversity can be mitigated through early-life intervention (Britto et al., 2017).
While much of the global effort to improve child development over the last decade has focused
on nurturing care interventions that target caregivers and children (World Bank, 2018), there is
growing evidence that addressing household poverty can positively impact children. Most
notably, several studies conducted in low- and middle-income countries have documented
positive impacts of cash transfer programs on child development outcomes (Barham et al.,
2013; Fernald et al., 2019; Fernald et al., 2011; Macours et al., 2012; Paxson, 2010). While the
Graduating to Resilience activity was not explicitly designed to influence child development, it
includes components that we hypothesize could positively impact developmental outcomes. In
addition to monthly cash transfers, coaching sessions included infant and mother nutrition
counseling, a cornerstone of the Nurturing Care Framework (World Bank, 2018).
This study is an intervention trial that aims to estimate the impact of the Graduating to
Resilience activity on child development in Uganda. We revisited a sample of households
enrolled in the Graduating to Resilience trial conducted in Uganda in 2019–2021 (AEARCTR0004080) and assessed children born during the intervention period.
2 See references in Section 8.
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Methodology
3
2. Methodology
2.1. Randomization
In the Graduating to Resilience trial, villages were randomly assigned to either a treatment or
control group. Within treatment villages, participants were randomly assigned at the household
level to one of three intervention conditions or a control condition:
• T1 (Individual, asset): consumption support, cash asset transfer, coaching in
individual household visits;
• T2 (Group, asset): consumption support, cash asset transfer, coaching in a group
setting, and all other aspects of the activity;
• T3 (Individual, no asset): consumption support, no cash asset transfer, coaching in
individual household visits, and all other aspects of the activity; or
• C1 (spillover control, "Control in treatment villages"): no intervention.
IPA revisited T1, T2, and C1 households within treatment villages for this study. Based on the
Graduating to Resilience trial results, we expect within-village spillovers to be minimal.
2.2. Empirical Strategy
In our main analysis, we estimate the average treatment effects of the Graduating to Resilience
Activity on all primary and secondary outcomes using an intention-to-treat approach. We
combine the T1 and T2 groups into a single intervention group for our analysis. The results of
the Graduating to Resilience trial indicate that impacts on household assets, consumption,
income, and food security were similar in T1 and T2.
2.3. Analysis
We fit a set of unadjusted and adjusted linear regression models to estimate average treatment
effects. All models include variables used for stratification in the original randomization
procedure. To improve precision, unadjusted models include child age in months; and adjusted
models include the following additional covariates: gender; caregiver age; and food security
(household dietary diversity score) measured at baseline of the Graduating to Resilience trial.
TOPS Uganda Graduation RCT Associate Award
Study Sample
4
3. Study Sample
The results of the original Graduating to Resilience evaluation indicate similar, strong treatment
effects in Arm 1 and Arm 2 and smaller effects in Arm 3. For this child development activity, we
analyze T1 and T2 as a single combined intervention group and compare them to the control
group. We restricted the study to children born between April 2019 and June 2020, as they were
exposed to the Graduating to Resilience activity from birth.
IPA enrolled 1,688 caregiver-child dyads in the study in 57 study villages3 (21 in the settlement
and 36 in the host community).
Based on household roster data collected during the endline survey for the original Graduating
to Resilience evaluation, we expected to enroll 570 dyads from T1, 590 from T2, and 528 from
Spillover Control. Children were 26–43 months of age at the time of the follow-up assessment.
Table 1. Number of households and villages, by community
Total Host Refugee
Villages 57 36 21
Households 1,688 703 985
3 Some “villages” were the result of combining or splitting up administratively assigned villages to organize
implementation and the intervention. In this report, we refer to the villages as they are used in the study rather
than referring to the local administrative units.
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Data Collection
5
4. Data Collection
An extensive enumerator training took place in Kampala from August 8 to August 30, 2022.
Esther Nalule—from the CURE Children’s Hospital of Uganda in Mbale—led the training of 41
field officers. Esther has many years of experience administering and training BSID-III. On
September 1, after the training, the team traveled to Kamwenge. From September 2 to
September 13, the team piloted the instrument.
The data collection was led by IPA’s Research Associate Allan Claudio Katimbo Katurebe. It
started on September 14, 2022, and ended on November 9, 2022. IPA deployed 36 field officers,
including 22 Enumerators, four Mobilizers, six Team Leaders, three Auditors, and one Associate
Field Manager.
IPA field staff interviewed 1,503 households. Enumerators conducted an average of two surveys
per day per enumerator. The table below shows the response rate per community and arm.
Table 2. Response rate per community and arm
Overall Host Refugee
Target Surveyed Target Surveyed Target Surveyed
T1: Individual coaching + asset 570 89% 250 88% 320 89%
T2: Group coaching + asset 590 88% 229 87% 361 89%
Spillover control 528 90% 224 88% 304 92%
Total 1,688 89% 703 88% 985 90%
4.1. Questionnaire
The questionnaire included four modules: 1) Bayley Scales for Infant and Toddler Development,
2) Caregiver-Reported Early Development Index, 3) health of the children, and 4) household
members' information (roster).
The Bayley Scales of Infant and Toddler Development (BSID) assesses five domains of
development: cognition, language, motor, social-emotional and adaptive behavior. Each domain
includes age-appropriate items that capture a child’s success in reaching standard behavioral
milestones. The instrument is administered to the child. It involves interaction between the
child and the assessor and observations in a series of tasks. BSID composite domain scores are
calculated based on the number of tasks the child successfully completes.
The second part of the questionnaire, the Caregiver-Reported Early Development Instruments
(CREDI), is administered to the main caregiver. It measures early childhood development (ECD)
for children from birth to age 3. The instrument gathers information on the development of five
interrelated domains: motor, cognitive, language, and social-emotional.
TOPS Uganda Graduation RCT Associate Award
Data Collection
6
The questionnaire was translated into and administered in Swahili, Kinyabwisha, and
Runyankole. Responses were collected using the SurveyCTO data collection application. The
survey took, on average, 154 minutes to administer.
4.2. Outcomes Measured
4.2.1. Primary Outcome
Primary outcomes are domain-specific child development scores measured using the Bayley
Scales for Infant and Toddler Development version III (BSID-III). The BSID-III assesses five
domains of skill development: cognition, language, motor, social-emotional, and adaptive
behavior. Each domain is examined as a separate primary outcome. Domains include a set of
age-appropriate tasks that the child is asked to complete. The BSID-III was adapted to the local
context, and a team of enumerators underwent 3 weeks of training before starting assessments.
Composite scores were converted to z-scores by standardizing within the study population.
4.2.2. Secondary Outcome
Secondary outcomes are domain-specific child development scores measured using the CREDI.
Like the BSID-III, the CREDI assesses cognitive, language, motor, and social-emotional skills.
While the BSID-III relies on direct assessments of children, the CREDI is based on caregiver
reporting on child skills. Raw item data were converted to z-scores by standardizing within the
study population.
4.3. Attrition
Of the total sample, 185 households did not respond to the survey.
Table 3. Number of households not surveyed, by community
Target Not surveyed %
Host 703 85 12%
Refugee 985 100 10%
Overall 1,688 185 11%
Table 4 shows the reasons why a participant was not surveyed. The most frequent reason was
that households left their village (77%). The second most important reason for dropout is due to
the death of the child (20%). A larger share of households in the host community (29%) was
affected by a child death than in the refugee community (12%).
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Data Collection
7
Table 4. Reasons for not being surveyed, by community
Overall Host Refugee
% N % N % N
Household relocated 77% 185 71% 85 83% 100
Child died 20% 185 29% 85 12% 100
The child/respondent refused 2% 185 0% 85 3% 100
Other reason 1% 185 0% 85 2% 100
In Table 5, we observe no significant difference in attrition between the pooled treatment and
spillover control.
Table 5. Attrition across experimental groups and community
Variables
(1) (2) (3)
All Host Refugee
Arm 1 -0.01 0.00 -0.03
(0.02) (0.03) (0.02)
Arm 2 -0.03 -0.01 -0.04
(0.02) (0.03) (0.02)
Observations 1,688 703 985
R-squared 0.03 0.04 0.02
Mean of control 0.900 0.880 0.920
SD of control 0.300 0.330 0.280
Note: Robust standard errors in parentheses. *** p<0.01, ** p<0.05, * p<0.1
TOPS Uganda Graduation RCT Associate Award
Sample Characteristics
8
5. Sample Characteristics
As shown in Table 6, 51% of the children interviewed were female and, on average, were 34
months old. In almost all households, the main caregiver was a woman.
Table 6. Demographics
Description Mean C.I. Lower C.I. Upper N
Female child 51% 49% 54% 1,503
Child's age in
months 34 34 35 1,503
Caregiver is a
woman 98% 97% 98% 1,492
Caregiver's age in
years 34 33 34 1,492
Note: the gender and age of the main caregiver of six households are unknown; the respondent refused to answer or
did not know.
Additionally, IPA collected information about children's health. About half (49%) of children
consumed orange flesh sweet potato, and a high percentage of children (77%) received drugs
for intestinal worms. One-quarter of children had diarrhea in the last two weeks; among those,
23% had blood in their stool and were treated with oral rehydration solution and zinc (40%), and
drugs (35%).
Table 7. Child Health
Description Mean C.I. Lower C.I. Upper N
Consumed orange flesh sweet potato in the last 7 days 49% 46% 51% 1,503
Was given drugs for intestinal worms 77% 75% 79% 1,503
Had diarrhea in the last 2 weeks 25% 23% 27% 1,503
There was blood in the stools 23% 19% 27% 379
Diarrhea was treated with:
Fluid from Oral Rehydration Therapy sachet and Zinc 40% 35% 45% 379
Drugs 35% 30% 40% 379
Recommended homemade fluid 15% 11% 18% 379
Herbal medicine 13% 9% 16% 379
Other 4% 2% 6% 379
Had a cough or difficulty breathing in the last 2 weeks 45% 43% 48% 1,503
Notes: Drugs include Flagyl, ciprofloxacin, deworming, Cipro, Loprade, and metronidazole tablets.
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Results
9
6. Results
IPA estimated the average treatment effects of the treatment (Arm 1 and Arm 2) using linear
regressions. For each household 𝑖𝑖 in village 𝑣𝑣 we specify:
𝑌𝑌𝑖𝑖,𝑣𝑣 = 𝛽𝛽0 + 𝛽𝛽1𝑇𝑇𝑇𝑇𝑇𝑇𝑇𝑇𝑇𝑇𝑇𝑇𝑇𝑇𝑇𝑇𝑇𝑇 + 𝑋𝑋𝑖𝑖𝑦𝑦 +𝛼𝛼𝑣𝑣 + 𝜀𝜀𝑖𝑖
Where Y is an outcome variable of interest, αv captures village fixed effects, and treatment
indicates random assignment between treatment (Arm1 or Arm 2) and control group. A vector
of individual-level covariates was included, 𝑋𝑋𝑖𝑖, which includes child gender, child age in months,
HDDS, and caregiver’s age. The parameter 𝜀𝜀𝑖𝑖 is a zero mean error term. All the outcomes used in
the regression tables were converted to z-scores. We focus on estimates of 𝛽𝛽1 which reflects the
average causal impact of treatment versus households in control villages. For the main tables of
this report, we pool host and refugee samples, but separate results for each sample are
provided in the appendices.
6.1. Impact of the Program
We find that the Graduating to Resilience activity had no impact on children’s cognitive (β -0.05
[SE 0.06]), motor (β -0.06 [SE 0.05]), language (β -0.03 [SE 0.05]), or social-emotional
development (β -0.01 [SE 0.05]) as measured by the BSID (Table 8). Similar null results were
found for the same domains as measured by the CREDI (Table 9).
Table 8. Impact of the program BSID, adjusted
VARIABLES
(1) (2) (3) (4)
Cognitive Motor Language Social-emotional
Treatment (T1, T2) -0.05 -0.06 -0.03 -0.01
(0.06) (0.05) (0.05) (0.05)
Observations 1,496 1,496 1,496 1,496
INTERPRETATION OF REGRESSION TABLES
The results tables in this section show treatment effects estimated from set linear
regression models. The column titles indicate the outcomes. The first row shows the
difference in average outcomes levels between treatment (T1, T2) and control. The
average outcome for the control is shown in the lower half of the tables for reference.
The second row shows the standard error of the estimated difference. Asterisks in the
first row indicate levels of statistical significance for tests of the Null hypothesis of a
treatment effect of zero.
TOPS Uganda Graduation RCT Associate Award
Results
10
VARIABLES
(1) (2) (3) (4)
Cognitive Motor Language Social-emotional
R-squared 0.14 0.24 0.19 0.21
Mean of control 0.04 0.04 0.03 0.01
SD of control 1.06 1.05 1.02 1
Notes: Robust standard errors in parentheses. * Denotes statistical significance at the 10% level; ** at the 5% level;
and *** at the 1% level.
Table 9. Impact of the program CREDI, adjusted
VARIABLES
(1) (2) (3) (4)
Cognitive Language Motor Social-Emotional
Treatment (T1, T2) -0.02 -0.06 0.05 -0.00
(0.07) (0.06) (0.07) (0.08)
Observations 972 972 972 972
R-squared 0.07 0.07 0.10 0.07
Mean of control -0.95 -0.73 -0.96 -0.61
Standard Deviation
(SD) of control 1.03 0.80 1.05 1.13
Notes: Robust standard errors in parentheses. * Denotes statistical significance at the 10% level; ** at the 5% level;
and *** at the 1% level.
When combined with the null results on linear growth measured at the Cohort 1 endline, we
find no demonstrable effects of the Graduating to Resilience activity on young children’s
physical growth or development, despite substantial household-level impacts of the program on
assets, income, consumption, and food security. The implication is that the benefits of the
program that flowed to participating households did not cascade down to the youngest children
in a way that affected their growth and developmental trajectories within the timeframe of the
activity.
While recent studies of poverty alleviation programs show positive impacts on child
development outcomes (Barham et al., 2013; Fernald et al., 2019; Fernald et al., 2011; Macours
et al., 2012; Paxson, 2010), many of these programs included an explicit focus on child health
and nutrition, often through conditions placed on cash transfers provided to households. Recent
studies suggest that cash alone is unlikely to improve child outcomes (Macours et al., 2012;
Ahmed et al., 2019; Field & Maffioli, 2021). The Graduating to Resilience activity includes
monthly cash transfers along with some nutrition coaching. Results from the study reinforce
current understanding in the space which suggests that increasing the program’s focus on
children and intentionally incorporating evidence-based interventions into the design may be
necessary to generate meaningful improvements in child development outcomes.
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
References
11
7. References
Ahmed, A., Hoddinott, J.F., Roy, S., & Sraboni, E. (2019). Transfers, nutrition programming, and
economic well-being: Experimental evidence from Bangladesh. International Food Policy
Research Institute.
Barham, T., Macours, K., & Maluccio, J.A. (2013) Boys' cognitive skill formation and physical growth:
long-term experimental evidence on critical ages for early childhood interventions. American
Economic Review 103: 467-71.
Britto, P.R., Lye, S.J., Proulx, K., Yousafzai, A.K., Matthews, S.G., Vaivada, T., Perez-Escamilla, R., Rao, N.,
Ip, P., Fernald, L.C., & MacMillan, H. (2017). Nurturing care: promoting early childhood
development. Lancet 389(10064):91-102.
Fernald, L.C.H., & Hidrobo, H.M. (2011). Effect of Ecuador’s cash transfer program (Bono de Desarrollo
Humano) on child development in infants and toddlers: a randomized effectiveness trial. Social
Science and Medicine 72(9):1437–46.
Fernald, L.C.H., Gertler, P.J., & Neufeld, L.M. (2009). Ten-year impact of Oportunidades—Mexico’s
conditional cash transfer program—on child growth, cognition, language, and behavior. Lancet
374(9706):1997–2005.
Field, E.M., & Maffioli, E.M.(2021). Are behavioral change interventions needed to make cash transfer
programs work for children? Experimental evidence from Myanmar. National Bureau of
Economic Research.
Johnson, S.B., Riis, J.L., & Noble, K.G. (2016). State of the art review: poverty and the developing brain.
Pediatrics 4 (137).
Macours, K., Schady, N., & Vakis, R. (2012). Cash transfers, behavioral changes, and cognitive
development in early childhood: evidence from a randomized experiment.” American Economic
Journal: Applied Economics 4(2):247–73.
Nelson III, C.A., & Gabard-Durnam, L.J. (2020). Early adversity and critical periods: neurodevelopmental
consequences of violating the expectable environment. Trends in Neurosciences 3(3):133-43.
Paxson, C., & Schady, N. (2010). Does Money Matter? The effects of cash transfers on child development
in rural Ecuador.” Economic Development and Cultural Change 59(1): 187–229.
World Health Organization, United Nations Children’s Fund, & World Bank Group (2018). Nurturing care
for early childhood development: a framework for helping children survive and thrive to
transform health and human potential.
TOPS Uganda Graduation RCT Associate Award
Annex A: Treatment Effect, Unadjusted Models
12
Annex A: Treatment Effect, Unadjusted Models
Table 10. Impact of the program BSID, unadjusted
VARIABLES
(1) (2) (3) (4)
Cognitive Motor Language Socialemotional
Treatment (T1, T2) -0.05 -0.06 -0.03 -0.01
(0.06) (0.05) (0.05) (0.05)
Observations 1,503 1,503 1,503 1,503
R-squared 0.14 0.23 0.19 0.21
Mean of control 0.04 0.04 0.03 0.01
SD of control 1.06 1.05 1.02 1
Notes: Robust standard errors in parentheses. * Denotes statistical significance at the 10% level; ** at the 5% level;
and *** at the 1% level.
Table 11. Impact of the program CREDI, unadjusted
VARIABLES
(1) (2) (3) (4)
Cognitive Language Motor Socialemotional
Treatment (T1, T2) -0.03 -0.07 0.04 -0.01
(0.07) (0.06) (0.07) (0.08)
Observations 977 977 977 977
R-squared 0.07 0.06 0.10 0.07
Mean of control -0.95 -0.73 -0.96 -0.61
SD of control 1.03 0.80 1.05 1.13
Notes: Robust standard errors in parentheses. * Denotes statistical significance at the 10% level; ** at the 5% level;
and *** at the 1% level.
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex B: Treatment Effect Estimates, by Community
13
Annex B: Treatment Effect Estimates, by
Community
Treatment Effects in the Refugee Community
Table 12. Impact of the program BSID unadjusted, refugee
VARIABLES
(1) (2) (3) (4)
Cognitive Motor Language Socialemotional
Treatment (T1, T2)
0.03 -0.00 0.01 -0.03
(0.08) (0.07) (0.07) (0.07)
Observations 885 885 885 885
R-squared 0.12 0.24 0.18 0.18
Mean of control -0.07 0.02 0.05 -0.08
SD of control 1.24 1.19 1.10 0.99
Notes: Robust standard errors in parentheses. * Denotes statistical significance at the 10% level; ** at the 5% level;
and *** at the 1% level.
Table 13. Impact of the program BSID adjusted, refugee
VARIABLES
(1) (2) (3) (4)
Cognitive Motor Language Socialemotional
Treatment (T1, T2)
0.02 -0.00 0.01 -0.03
(0.08) (0.07) (0.07) (0.07)
Observations 884 884 884 884
R-squared 0.12 0.24 0.18 0.19
Mean of control -0.07 0.02 0.05 -0.08
SD of control 1.24 1.19 1.10 0.99
Notes: Robust standard errors in parentheses. * Denotes statistical significance at the 10% level; ** at the 5% level;
and *** at the 1% level.
TOPS Uganda Graduation RCT Associate Award
Annex B: Treatment Effect Estimates, by Community
14
Table 14. Impact of the program CREDI unadjusted, refugee
VARIABLES
(1) (2) (3) (4)
Cognitive Language Motor Socialemotional
Treatment (T1, T2) -0.03 -0.04 0.00 -0.01
(0.09) (0.07) (0.09) (0.11)
Observations 565 565 565 565
R-squared 0.03 0.02 0.07 0.03
Mean of control -1.08 -0.80 -1.10 -0.74
SD of control 0.99 0.72 1.02 1.14
Notes: Robust standard errors in parentheses. * Denotes statistical significance at the 10% level; ** at the 5% level;
and *** at the 1% level.
Table 15. Impact of the program CREDI adjusted, refugee
VARIABLES
(1) (2) (3) (4)
Cognitive Language Motor Social emotional
Treatment (T1, T2) -0.02 -0.05 0.01 -0.01
(0.09) (0.07) (0.09) (0.11)
Observations 564 564 564 564
R-squared 0.03 0.03 0.07 0.03
Mean of control -1.08 -0.80 -1.10 -0.74
SD of control 0.99 0.72 1.02 1.14
Notes: Robust standard errors in parentheses. * Denotes statistical significance at the 10% level; ** at the 5% level;
and *** at the 1% level.
Treatment Effects in the Host Community
Table 16. Impact of the program BSID unadjusted, host
VARIABLES
(1) (2) (3) (4)
Cognitive Motor Language Social emotional
Treatment (T1, T2) -0.15** -0.14* -0.10 0.02
(0.07) (0.08) (0.08) (0.09)
Observations 618 618 618 618
R-squared 0.17 0.22 0.21 0.21
Mean of control 0.19 0.07 0.01 0.14
SD of control 0.70 0.82 0.90 1.01
Notes: Robust standard errors in parentheses. * Denotes statistical significance at the 10% level; ** at the 5% level;
and *** at the 1% level.
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex B: Treatment Effect Estimates, by Community
15
Table 17. Impact of the program BSID adjusted, host
VARIABLES
(1) (2) (3) (4)
Cognitive Motor Language Social-emotional
Treatment (T1, T2) -0.15** -0.15* -0.09 0.02
(0.08) (0.08) (0.08) (0.09)
Observations 612 612 612 612
R-squared 0.18 0.23 0.22 0.21
Mean of control 0.19 0.07 0.01 0.14
SD of control 0.70 0.82 0.90 1.01
Notes: Robust standard errors in parentheses. * Denotes statistical significance at the 10% level; ** at the 5% level;
and *** at the 1% level.
Table 18. Impact of the program CREDI unadjusted, host
VARIABLES
(1) (2) (3) (4)
Cognitive Language Motor Social-emotional
Treatment (T1, T2) -0.02 -0.11 0.11 -0.01
(0.12) (0.10) (0.12) (0.12)
Observations 412 412 412 412
R-squared 0.07 0.08 0.07 0.08
Mean of control -0.76 -0.63 -0.75 -0.43
SD of control 1.06 0.89 1.06 1.10
Notes: Robust standard errors in parentheses. * Denotes statistical significance at the 10% level; ** at the 5% level;
and *** at the 1% level.
Table 19. Impact of the program CREDI adjusted, host
VARIABLES
(1) (2) (3) (4)
Cognitive Language Motor Social-emotional
Treatment (T1, T2)
0.01 -0.08 0.13 0.02
(0.12) (0.10) (0.12) (0.13)
Observations 408 408 408 408
R-squared 0.08 0.09 0.08 0.08
Mean of control -0.76 -0.63 -0.75 -0.43
SD of control 1.06 0.89 1.06 1.10
Notes: Robust standard errors in parentheses. * Denotes statistical significance at the 10% level; ** at the 5% level;
and *** at the 1% level.
TOPS Uganda Graduation RCT Associate Award
Annex C: Balance Test
16
Annex C: Balance Test
Table 20. Balance test
Control Treatment (T1, T2)
Variable N Mean N Mean
Difference
(p-value)
Age of household head 528 34.54 1160 35.01 -0.47
(0.43)
Female household head 528 0.5 1160 0.49
0.01
(0.67)
Household head completed primary education
or higher 528 0.19 1160 0.2 -0.01
(0.68)
Number of children under 18 in household 528 3.52 1160 3.6 -0.08
(0.44)
Number of household members 528 5.66 1160 5.78 -0.12
(0.32)
Number of rooms in the main house 528 2.75 1160 2.86 -0.11
(0.09)
Number of crops grown in the March to May
2018 season
528 2.59 1160 2.47
0.12
(0.17)
HDDS Score (0-12) 528 3.04 1160 3.01
0.03
(0.64)
Number of sources of income 528 2.5 1160 2.45
0.05
(0.44)
Joint Test P-Value: 0.81
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex D: Pre-Analysis Plan
17
Annex D: Pre-Analysis Plan
Background
This study is an intervention trial that aims to estimate the impact of the Graduating to
Resilience (G2R) program on child development in Uganda. In previous trials, the G2R program
has generated large, positive impacts on household assets, consumption, income and food
security. We will revisit a sample of households enrolled a G2R trial conducted in Uganda in
2019-2021 (AEARCTR-0004080) and assess children born during the intervention period.
A large body of evidence demonstrates that early exposure to poverty and related adverse
experiences, including toxic stress, malnutrition, and psychosocial deprivation, impedes child
brain development and skill formation [1,2]. A similarly robust literature shows that the negative
effects of poverty-related adversity can be mitigated through early-life intervention [3]. The G2R
program is unique in the holistic sense in which it improves the environment in which children
develop.
Randomization
In the G2R trial in Uganda, villages were randomly assigned to either treatment or control
villages. Within treatment villages, participants were randomly assigned at the household-level
to one of three intervention conditions or a control condition:
• T1, “Individual, asset”: consumption support, cash asset transfer, coaching in individual
household visits
• T2, “Group, asset”: consumption support, cash asset transfer, coaching in group setting
and all other aspects of program
• T3, “Individual, no asset”: consumption support, no cash asset transfer, coaching in
individual household visits and all other aspects of program
• C1, “Control in treatment villages”: no intervention
For this study, we will revisit T1, T2, and C1 households within treatment villages. Based on the
results of the G2R trial, we expect within-village spillovers to be minimal.
Empirical strategy
In our main analysis, we will estimate average treatment effects of the G2R program on all
primary and secondary outcomes using an intention-to-treat approach. We will combine T1 and
T2 groups into a single intervention group for our analysis. The results of the G2R trial indicate
that impacts on household assets, consumption, income, and food security were similar in T1
and T2.
We will also examine heterogeneity in treatment effects by the duration of program exposure in
utero. The relative contributions of poverty-related adversity experienced in utero versus postbirth on child development is an important research question. We will also estimate impacts
within refugee and host (i.e., non-refugee) strata, as the population of the G2R trial was drawn
from these two communities.
TOPS Uganda Graduation RCT Associate Award
Annex D: Pre-Analysis Plan
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Analysis
We will fit a set of unadjusted and adjusted linear regression models to estimate average
treatment effects. All models will include variables used for stratification in the original
randomization procedure. Adjusted models will include the following additional covariates to
improve precision: child age in months and gender; caregiver age and education; and measures
of household consumption and food insecurity measured at baseline of the G2R trial.
Primary outcomes
Primary outcomes are domain-specific child development scores measured using the Bayley
Scales for Infant and Toddler Development version III (BSID-III). The BSID-III assesses five
domains of skill development: cognitive, language, motor, social-emotional, and adaptive
behavior. Each domain will be examined as a separate primary outcome. Domains include a set
of age appropriate tasks that the child is asked to complete. The BSID-III will be adapted to the
local context and a team of assessors will undergo three weeks of training prior to the start of
assessments. For each domain, raw data will be converted to norm-referenced z-scores using
the Bayley-III Scoring Assistant software.
Secondary outcome
Secondary outcomes are domain-specific child development scores measured using the
Caregiver Reported Early Development Instruments (CREDI). Like the BSID-III, the CREDI assesses
cognitive, language, motor, and social-emotional skills. While the BSID-III relies on direct
assessments of children, the CREDI is based on caregiver reporting on child skills. Raw item data
will be converted to norm-referenced z-scores for each domain using the CREDI scoring
procedure [4].
References
1. Johnson SB, Riis JL, Noble KG. State of the art review: poverty and the developing brain.
Pediatrics 2016;137(4).
2. Nelson III CA, Gabard-Durnam LJ. Early adversity and critical periods: neurodevelopmental
consequences of violating the expectable environment. Trends in Neurosciences
2020;43(3):133-43.
3. Britto PR, Lye SJ, Proulx K, Yousafzai AK, Matthews SG, Vaivada T, Perez-Escamilla R, Rao N,
Ip P, Fernald LC, MacMillan H. Nurturing care: promoting early childhood development.
Lancet 2017;389(10064):91-102.
4. Waldman M, McCoy DC, Seiden J, Cuartas J, CREDI Field Team, Fink G. Validation of motor,
cognitive, language, and socio-emotional subscales using the caregiver reported early
development instruments: an application of multidimensional item factor analysis.
International Journal of Behavioral Development 2021;45(4):368-77)
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex D: Pre-Analysis Plan
19
Annex E: Study Instrument
Field Question Answer
generated_note_name_22 Child Development Follow-up survey
caseid (required) Please, enter the household ID:
generated_note_name_27 (required) The ID number you registered, [caseid], is not in the sample.
Verify the ID number. Please, go back to correct any errors.
Question relevant when: ${caseid} != ${hhid}
enum (required) Please select your name 1 Enumerator name
team_leader (required) Please select your Team Leader 1 Team leader name
Introduction
confirm_info (required) Please confirm that the household you are at is where the following individuals live:
[pre_fullname_child] and
[pre_hhead_fullname] and
[pre_targetresp_fullname].
It is located in this village: [village].
We have this information about the address: [pre_address].
1 Yes
0 No
generated_note_name_80 In 2018 we came to your household to administer a survey. We came back again in 2019 or 2020. We may also have
interviewed you over the phone in 2020.
We would like to talk to the head of household, , and to .
confirm_hhead_present (required) Is [pre_hhead_fullname] available?
Question relevant when: ${pre_targetresp_relation} != 1
1 Yes
0 No
confirm_targetresp_present (required) Is [pre_targetresp_fullname] available? 1 Yes
0 No
survey_language (required) (Z112) [ENUMERATOR] Select the language in which the survey will be conducted. Ask the respondent in which
language he/she feels most comfortable.
Question relevant when: ${consentsurvey} >=1
1 Kinyabwisha
2 Swahili
3 Runyankole
-66 Other, specify
Introduction > Unavailable
Group relevant when: ${confirm_targetresp_present} =0
respavailable (required) Why is [pre_targetresp_fullname] not available? 1 Respondent is a minor
2 Respondent is not available
today, but will be available
some other time
3 Household is not known in
the village
4 Household moved elsewhere
5 Respondent is away for more
than one week
6 The respondent is not
capable of participating in the
survey (drunk, too ill, etc…)
7 The respondent speaks a
language that I cannot speak
8 Ineligible
0 The respondent died
-66 Other
respunavailable (required) Other, specify
Question relevant when: selected( ${respavailable} ,'-66')
Response constrained to: string-length(.) > 3
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Annex D: Pre-Analysis Plan
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Field Question Answer
contactsup [ENUMERATOR] Please contact your supervisor
Question relevant when: ${respunavailable} = 1 and ${respunavailable} = 3 and ${respunavailable} = 6
reschedule [ENUMERATOR] Please reschedule an interview with [pre_targetresp_fullname]
Question relevant when: ${respunavailable} = 2
Introduction > Unavailable > tracking
Group relevant when: ${respavailable} !=0
track_info Could you please give us information to help us find this person?
track_country (required) Country
Response constrained to: string-length(.) > 3
Field Question Answer
track_region (required) Region
Response constrained to: string-length(.) > 3
track_county (required) County
Response constrained to: string-length(.) > 3
track_subcounty (required) Subcounty
Response constrained to: string-length(.) > 3
track_parish (required) Parish
Response constrained to: string-length(.) > 3
track_town (required) Town
Response constrained to: string-length(.) > 3
track_phonenumber1 (required) Phonenumber1
Response constrained to: regex(.,'[0-9]{10}') or . = -99 or . = -88 or . = -55
track_phonenumber2 (required) Phonenumber2
Response constrained to: regex(.,'[0-9]{10}') or . = -99 or . = -88 or . = -55
Introduction > Available
Group relevant when: ${confirm_hhead_present} =1 or ${confirm_targetresp_present} =1
consent_read [ENUMERATOR] Read the information & consent form fully.
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
21
Field Question Answer
consent Introduction: Hello, my name is [enumerator]. I am working for Innovations for Poverty Action - a non-profit
development research organization based in the US and Uganda. We are currently conducting a research study to
learn about household livelihoods and well-being in your area to better understand the welfare of people like yourself.
This study covers approximately 1,500 households like yours in the Kamwenge area.
Invitation to participate:
We would like to invite you to participate in this survey. If you agree to participate, I will ask you questions about your
children’s abilities. We would also like to practice some exercises with them. In addition, we would like to ask you
questions about your own well-being. Your participation is completely voluntary. You can refuse to answer the entire
survey, stop the survey at any time by informing me that you wish to do so, or can tell us when a question makes you
uncomfortable and we will skip that question.
The survey will take approximately two hours (2) to answer. All identifying information will be encrypted and will not be
made public. Only the members of the research team will have access to them.
We would also like to use the tablet computer to record our current location and make audio recordings of your
answers. This information will help us collect accurate information and may also be used to take into account
respondents’ cultural backgrounds and other information that can tell us more about how someone is doing. As with all
information we collect, it will be used for research purposes only. The recordings are voluntary and are not a
requirement for participation in this survey. We will not record them against your will, and you will be asked to confirm if
you agree at the beginning of the survey.
Risks: As with all research, there is a chance that confidentiality could be compromised; however, we are taking
precautions to minimize this risk. Your participation in this study will be confidential and the answers you provide will
be stored securely in electronic form. Your name and any other identifying information will only be accessible to the
affiliated researchers and will never appear in any sort of report that might be published or shared with organizations
who may be interested in the results. There are no other anticipated risks from your participation in the study. This
study has been approved by an accredited Ugandan-based Research Ethics Committee (MUREC).
Benefits: You will receive a bar of soap as a token of appreciation for your participation. Apart from that, you will not
receive any program or services just by participating in this study. However, the information you provide will be very
valuable in understanding more about the people in this area.
Withdrawal: You may withdraw from this study or skip any question at any time and without any explanation. There will
be no consequences for deciding to withdraw or skip a question. You can use the contacts that we have provided you
with to inform the research team that you would like to withdraw after the interview. There are no circumstances under
which the research team will withdraw you from this study against your wishes.
Questions & Concerns: Please ask us anything you want to know about this project now or later. If you have questions
in the future regarding the research, please contact one of the members of our team: Andrew Chemonges, Senior
Field Manager at IPA Uganda, Tel: 0775 540282. If you have questions about your rights as a research subject or
regarding any damage attributable to the research and wish to discuss this with someone not involved in the study,
you may contact the Mildmay Uganda Research Ethics Committee (MUREC) at 0392174236 or the Uganda National
Council of Sciences and Technology (UNCST) at 0414705500.
Field Question Answer
Sponsor: This research is funded by the United States Agency for International Development Office of Food for Peace,
which aims to reduce hunger and malnutrition.
consent_understand [ENUMERATOR] Make sure that the respondent fully understands the information form before agreeing to sign the
consent.
consentsurvey (required) Have you understood everything, and do you agree to participate in this survey? 1 Yes
0 No
consentaudio (required) Do you consent to a possible audio recording?
Question relevant when: ${consentsurvey} =1
1 Yes
0 No
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Annex E: Study Instrument
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Field Question Answer
consentgps (required) Do you consent to have your current GPS location recorded?
Question relevant when: ${consentsurvey} =1
1 Yes
0 No
signature_note Enumerator: If the respondent consents to participate, please give them the consent form and have them sign on the
consent form
Question relevant when: ${consentsurvey} =1
consent_who (required) [ENUMERATOR] Who consented?
Question relevant when: ${consentsurvey} =1
1 Head of household: ...
2 Target respondent: ...
-66 Other, specify
consent_who_osp (required) Other, specify
Question relevant when: ${consent_who} =-66
Response constrained to: string-length(.) > 3
statusrespondent (required) Survey status for respondent if no consent:
Question relevant when: ${consentsurvey} =0
1 Everyone in household refused
2 Target person migrated out of
survey area (TO BE
CLARIFIED)
3 Target household not
identified/found
4 No one in household available
for whole survey period
statusrespondent_expl (required) For all reasons, give an explanation:
Question relevant when: ${consentsurvey} =0
Response constrained to: string-length(.) > 3
Introduction > Available > Contact information
Group relevant when: ${consentsurvey} =1
contact_intro (A009) I would like to begin the survey by asking or confirming the contacts we have for your household
tel1a (required) (A013) Please confirm the (first) telephone number of the head of household, [pre_hhead_fullname].
Question relevant when: ${pre_targetresp_relation} != 1
Response constrained to: regex(.,'[0-9]{10}') or . = -99 or . = -88 or . = -55
tel1b (required) (A014) Please confirm the (second) telephone number of the head of household, [pre_hhead_fullname].
Question relevant when: ${pre_targetresp_relation} != 1 and ${tel1a} !=-55
Response constrained to: regex(.,'[0-9]{10}') or . = -99 or . = -88 or . = -55
tel1c (required) (A015) What is the first telephone number of [pre_targetresp_fullname]?
Response constrained to: regex(.,'[0-9]{10}') or . = -99 or . = -88 or . = -55
tel1d (required) (A016) What is the second telephone number of [pre_targetresp_fullname]?
Question relevant when: and /ugs_coh2_childdev_print/intro/available/contact/tel1c !=-55
Response constrained to: regex(.,'[0-9]{10}') or . = -99 or . = -88 or . = -55
tel2_has (required) (A017) Is there someone else in the household with a telephone number? 1 Yes
0 No
tel2 (required) (A018) What is the telephone number of someone else in the household?
Question relevant when: ${tel2_has} = 1
Response constrained to: regex(.,'[0-9]{10}') or . = -99 or . = -88 or . = -55
contact1_has (required) (A019) Is there a person, outside the household, who could help us find you if we cannot find you in the future? 1 Yes
0 No
contact1 (required) (A020) Please give the name of the first person, outside the household, who could help us find you if we cannot find
you in the future.
Question relevant when: ${contact1_has} = 1
Response constrained to: string-length(.) > 3
contact1_rel (required) (A021) What is their relationship to the household head?
Question relevant when: ${contact1_has} = 1
Response constrained to: . != 1
1 Household head
2 Spouse/partner
3 Son/daughter
4 Stepson/stepdaughter
5 Adopted
6 Grandchild
7 Brother/sister
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
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Field Question Answer
8 Niece/nephew
9 Father/moter
10 Step brother/step sister
11 Grandparent
12 Great Grandchild
13 Household help/related to
household help
14 Lodger
15 Friends/friend's family
16 Son-in-law/daughter-in-law
17 Brother-in-law/sister-in-law
18 Mother-in-law/father-in-law
19 Cousin
20 Aunt/Uncle
21 Fiance
22 Foster child
23 Polygamous co-wife/husband
30 Neighbors
24 Employer
25 Village Health Technician
(VHT)
26 Landlord
27 Village leader
28 Step niece/step nephew
29 Priest/religious leader
-66 Other
contact1_rel_osp (required) (A022) Please specify: What is their relationship to the head of household?
Question relevant when: selected( ${contact1_rel} ,'-66')
Response constrained to: string-length(.) > 3
contact1_tel (required) (A023) What is their telephone number ?
Question relevant when: ${contact1_has} = 1
Response constrained to: regex(.,'[0-9]{10}') or . = -99 or . = -88 or . = -55
contact2_has (required) (A024) Is there a second person that could help us find you in the future?
Question relevant when: ${contact1_has} = 1
1 Yes
0 No
contact2 (required) (A025) Please give the name of a second person, outside the household, who could help us find you if we cannot find
you in the future.
Question relevant when: ${contact2_has} = 1
Response constrained to: string-length(.) > 3
contact2_rel (required) (A026) What is their relationship to the household head?
Question relevant when: ${contact2_has} = 1
Response constrained to: . != 1
1 Household head
2 Spouse/partner
3 Son/daughter
4 Stepson/stepdaughter
5 Adopted
6 Grandchild
7 Brother/sister
8 Niece/nephew
9 Father/moter
10 Step brother/step sister
11 Grandparent
12 Great Grandchild
13 Household help/related to
household help
14 Lodger
15 Friends/friend's family
16 Son-in-law/daughter-in-law
17 Brother-in-law/sister-in-law
18 Mother-in-law/father-in-law
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
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Field Question Answer
19 Cousin
20 Aunt/Uncle
21 Fiance
22 Foster child
Field Question Answer
23 Polygamous co-wife/husband
30 Neighbors
24 Employer
25 Village Health Technician
(VHT)
26 Landlord
27 Village leader
28 Step niece/step nephew
29 Priest/religious leader
-66 Other
contact2_rel_osp (required) (A027) Please specify: what is their relationship to the head of household?
Question relevant when: selected( ${contact2_rel} ,'-66')
Response constrained to: string-length(.) > 3
contact2_tel (required) (A028) What is their telephone number ?
Question relevant when: ${contact2_has} = 1
Response constrained to: regex(.,'[0-9]{10}') or . = -99 or . = -88 or . = -55
address (required) (A029) Currently, we have this information to help find this dwelling in the future: [pre_address].
Please add additional information to help find dwelling in the future
Response constrained to: string-length(.) > 3
eligible_child
Group relevant when: ${consentsurvey} =1
generated_note_name_145 I would like to practice some exercises with your child [pre_fullname_child]
child_available (required) Is [pre_fullname_child] available? 1 Yes
0 No
child_noavailable (required) Why is [pre_fullname_child] not available?
Question relevant when: ${child_available} =0
1 The child is sick
2 The child is distracted and
not willing to participate
3 The child is not at home
-66 Other
child_noavailable_ot (required) Other, specify
Question relevant when: ${child_noavailable} =-66
Response constrained to: string-length(.) > 3
child_fullname (required) Could confirm the child's full name:
Question relevant when: ${child_available} =1
Response constrained to: string-length(.) > 3
age_child (required) What is [pre_fullname_child] age in years?
Question relevant when: ${child_available} =1
dob (required) When was [pre_fullname_child] born?
Capture the exact date
Question relevant when: ${age_child} >=2 and ${age_child} <=3
Response constrained to: . <= date(today())
another_child (required) Is there another child available who was born between April 2019 and June 2020?
Question relevant when: ${age_child} <=1 or ${age_child} >=4 or ${dob} <= date('2019-03-31') or ${dob} >=
date('2020-07-01') or ${child_available} =0
1 Yes
0 No
dob_ot (required) When was she/he born?
Capture the exact date
Question relevant when: ${another_child} =1
Response constrained to: . >= date('2019-04-01') and . <= date('2020-06-30')
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
25
Field Question Answer
fullname_child_ot (required) What is the full name of the child?
Question relevant when: ${another_child} =1
Response constrained to: string-length(.) > 3
gender_child (required) What is the gender of [fullname_child]?
Question relevant when: ${surveyecd} =1
0 Male
1 Female
fullname_caregiver (required) What is the name of the primary caregiver for [fullname_child]?
Question relevant when: ${surveyecd} =1
Response constrained to: string-length(.) > 3
relation_to_caregiver (required) What is [fullname_child] relationship to [fullname_caregiver]?
Question relevant when: ${surveyecd} =1
1 Head
2 Spouse/partner
3 Son/daughter
4 Stepson/daughter
5 Adopted
6 Grandchild
7 Brother/sister
Field Question Answer
8 Niece/Nephew
9 Father/mother
10 Step brother/sister
11 Grandparent
12 Great-grandchild
13 Other family
14 Household help
15 Lodger
16 Friends
17 Son/daughter in law
18 Brother/sister in law
19 Mother/father in law
-66 Other (specify)
confirm_caregiver_present (required) Is [fullname_caregiver] available to answer questions about [fullname_child]'s abilities?
Question relevant when: ${surveyecd} =1
1 Yes
0 No
Survey
Group relevant when: ${confirm_caregiver_present} =1
Survey > Child Development Survey
Survey > Child Development Survey > determine_start_cog
generated_note_name_175 The following questions should be answered by [fullname_caregiver] and [fullname_child]. It will be small tasks the
child is asked to complete.
Now, I'm going to ask you a couple of questions to determine where we should start the the cognitive subtest.
Survey > Child Development Survey > determine_start_cog > gr_start_q_cog
Group relevant when: ${month_calculate_str} >=39
generated_note_name_178 Start point Q
pre_cog_67 (required) 67. Does the child correctly imitate both steps?
Materials: Small yellow duck, and Spoon
Trials: 3
1 Yes
0 No
Survey > Child Development Survey > determine_start_cog > gr_start_q_cog > pre_gr_cog_68
Group relevant when: ${pre_cog_67} =1
note_pre_cog_68 68. Does the child place yellow, blue, and green disks on or near matching crayons in Stimulus Book, or point to
matching crayons?
Materials: Stimulus Book (p.25), Red, yellow, blue, and green disks.
1 Yes
0 No
pre_cog_item_68_1 (required) Yellow? 1 Yes
0 No
pre_cog_item_68_2 (required) Blue? 1 Yes
0 No
pre_cog_item_68_3 (required) Green? 1 Yes
0 No
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
26
Field Question Answer
pre_cog_69 (required) 69. Does the child use imaginary objects in play?
Materials: Plastic cups, Spoon
Doll, Bear, Washcloths, Small ball, and Other objects of interest
Question relevant when: ${pre_cog_68} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_cog > gr_start_p_cog
Group relevant when: ( ${month_calculate_str} >=33 and ${month_calculate_str} <39) or ${pre_cog_67} =0 or ${pre_cog_68} =0 or ${pre_cog_69} =0
generated_note_name_193 Start point P
pre_cog_63 (required) 63. Does the child correctly assemble object within 90 seconds, in either trial?
Materials: Ice cream cone puzzle and Stopwatch.
Time: 90 seconds
Trials: 2
1 Yes
0 No
Survey > Child Development Survey > determine_start_cog > gr_start_p_cog > pre_gr_cog_64
Group relevant when: ${pre_cog_63} =1
note_pre_cog_64 64. Does the child correctly identify matching picture?
Materials: Stimulus Book (pp.17-23)
1 Yes
0 No
pre_cog_item_64_1 (required) Bus? 1 Yes
0 No
pre_cog_item_64_2 (required) Bicycle? 1 Yes
0 No
pre_cog_item_64_3 (required) Tree? 1 Yes
0 No
pre_cog_item_64_4 (required) Telephone? 1 Yes
0 No
pre_cog_65 (required) 65. Does the child take an object and pretends it is something else?
Materials: Plastic cups, Spoon, Doll, Washcloths, Block, and Other objects of interest
Question relevant when: ${pre_cog_64} =1
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > determine_start_cog > gr_start_o_cog
Group relevant when: ( ${month_calculate_str} >28.5 and ${month_calculate_str} <33) or ${pre_cog_63} =0 or ${pre_cog_64} =0 or ${pre_cog_65} =0
generated_note_name_209 Start point O
pre_cog_60 (required) 60. Does the child correctly place all three pieces while board is in rotated position?
Materials: Pink board, and Red block set (square, circle, triangle)
1 Yes
0 No
pre_cog_61 (required) 61. Does the child correctly assemble object within 90 seconds in either trial?
Materials: Ball puzzle, and Stopwatch
Time: 90 seconds
Trials: 2
Question relevant when: ${pre_cog_60} =1
1 Yes
0 No
pre_cog_62 (required) 62. Does the child place all six pegs in pegboard within 25 seconds?
Materials: Pegboard, 6 yellow pegs, and Stopwatch
Time: 25 seconds
Question relevant when: ${pre_cog_61} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_cog > gr_start_n_cog
Group relevant when: ( ${month_calculate_str} >25.5 and ${month_calculate_str} <=28.5) or ${pre_cog_60} =0 or ${pre_cog_61} =0 or ${pre_cog_62} =0
generated_note_name_218 Start point N
Survey > Child Development Survey > determine_start_cog > gr_start_n_cog > pre_gr_cog_56
pre_cog_56 (required) 56. Does the child correctly place all three pieces within 180 seconds?
Materials: Pink board, Red block set (square, circle, triangle), and Stopwatch
Time: 180 seconds
1 Yes
0 No
pre_cog_56a (56a) # pieces placed correctly (180 seconds):
Response constrained to: . <= 3
pre_cog_57 (required) 57. Does the child use pencil to attempt to obtain duck?
Materials: Pencil, and Small red duck
Trials: 2
Question relevant when: ${pre_cog_56} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_cog > gr_start_n_cog > pre_gr_cog_58
Group relevant when: ${pre_cog_57} =1
pre_cog_58 (required) 58. Does the child correctly place at least four pieces within 150 seconds?
Materials: Blue board Blue block set (4 round, 5 square), and Stopwatch
Time: 150 seconds
1 Yes
0 No
pre_cog_58a (58a) Completion time:
pre_cog_58b (58b) # of pieces:
Survey > Child Development Survey > determine_start_cog > gr_start_lm_cog
Group relevant when: ( ${month_calculate_str} >19.5 and ${month_calculate_str} <=25.5) or ${pre_cog_56} =0 or ${pre_cog_57} =0 or ${pre_cog_58} =0
generated_note_name_234 Start point L and M
Survey > Child Development Survey > determine_start_cog > gr_start_lm_cog > pre_gr_cog_45
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
27
Field Question Answer
pre_cog_45 (required) 45. Does the child find bracelet by looking first under correct washcloth when hidden on both left and right sides?
Materials: Glitter bracelet, and 2 washcloths
Trials: 2
1 Yes
0 No
pre_cog_item_45_1 Trial 1: 1 Right
2 Left
pre_cog_item_45_2 Trial 2: 1 Right
2 Left
pre_cog_46 (required) 46. Does the child unscrew lid until it comes off?
Materials: Bottle with lid
Question relevant when: ${pre_cog_45} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_cog > gr_start_lm_cog > pre_gr_cog_47
Group relevant when: ${pre_cog_46} =1
pre_cog_47 (required) 47. Does the child place at least one peg two or more times in the same or different hole(s)?
Materials: Pegboard, 6 yellow pegs, and Stopwatch.
Time: 70 seconds per trial
Trials:
3
1 Yes
0 No
pre_cog_47a (47a) Trial 1 Completion time (all 6 pegs):
pre_cog_47b (47b) Trial 2 Completion time (all 6 pegs):
pre_cog_47c (47c) Trial 3 Completion time (all 6 pegs):
Survey > Child Development Survey > determine_start_cog > gr_start_k_cog
Group relevant when: ( ${month_calculate_str} >16.5 and ${month_calculate_str} <=19.5) or ${pre_cog_45} =0 or ${pre_cog_46} =0 or ${pre_cog_47} =0
generated_note_name_252 Start point K
Survey > Child Development Survey > determine_start_cog > gr_start_k_cog > pre_gr_cog_40
pre_cog_40 (required) 40. Does the child find bracelet by looking first under correct washcloth when hidden on both left and right sides?
Materials: Glitter bracelet, and 2 washcloths
Trials: 2
1 Yes
0 No
pre_cog_item_40_1 Trial 1: 1 Right
2 Left
pre_cog_item_40_2 Trial 2: 1 Right
2 Left
pre_cog_41 (required) 41. Does the child obtain ring and suspends it by string without the ring touching the table?
Materials: Ring with string
Question relevant when: ${pre_cog_40} =1
1 Yes
0 No
pre_cog_42 (required) 42. Does the child purposely remove uncooked bean from bottle using some form of directed effort?
Materials: Uncooked beans, and Bottle (without lid)
Trials: 3
1 Yes
Field Question Answer
Question relevant when: ${pre_cog_41} =1 0 No
Survey > Child Development Survey > determine_start_cog > gr_start_j_cog
Group relevant when: ( ${month_calculate_str} >13.5 and ${month_calculate_str} <=16.5) or ${pre_cog_40} =0 or ${pre_cog_41} =0 or ${pre_cog_42} =0
generated_note_name_265 Start point J
pre_cog_34 (required) 34. Does the child look into empty cup for blocks?
Materials: 3 blocks without holes, and Cup with handle.
Trials: 2
1 Yes
0 No
pre_cog_35 (required) 35. Does the child take all three blocks out of cup?
Materials: 3 blocks without holes, Cup with handle, and Stopwatch.
Time: 2 minutes
Question relevant when: ${pre_cog_34} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_cog > gr_start_j_cog > pre_gr_cog_36
Group relevant when: ${pre_cog_35} =1
pre_cog_36 (required) 36. Does the child place at least one block in or over cup, even if he or she does not release it?
Materials: 9 blocks, and Cup with handle.
1 Yes
0 No
pre_cog_36a (36a) Number of blocks in cup:
Survey > Child Development Survey > determine_start_cog > gr_start_i_cog
Group relevant when: ( ${month_calculate_str} >=11 and ${month_calculate_str} <=13.5) or ${pre_cog_34} =0 or ${pre_cog_35} =0 or ${pre_cog_36} =0
generated_note_name_277 Start point I
pre_cog_31 (required) 31. Does the child hold bell by handle and purposely rings it?
Materials: Bell
1 Yes
0 No
pre_cog_32 (required) 32. Does the child regard one or more specific pictures with interest or recognition?
Materials: Picture Book
Question relevant when: ${pre_cog_31} =1
1 Yes
0 No
pre_cog_33 (required) 33. Does the child retain first two blocks for at least 3 seconds after visually attending to third block? 1 Yes
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
28
Field Question Answer
Materials: 3 blocks without holes
Question relevant when: ${pre_cog_32} =1
0 No
Survey > Child Development Survey > determine_start_cog > gr_start_h_cog
Group relevant when: ( ${month_calculate_str} >=9 and ${month_calculate_str} <11) or ${pre_cog_31} =0 or ${pre_cog_32} =0 or ${pre_cog_33} =0
generated_note_name_286 Start point H
pre_cog_25 (required) 25. Does the child look for fallen toy by looking toward floor?
Materials: Squeeze toy
1 Yes
0 No
pre_cog_26 (required) 26. Does the child manipulate bell while looking at it with interest?
Materials: Bell
Question relevant when: ${pre_cog_25} =1
1 Yes
0 No
pre_cog_27 (required) 27. Does the child hold first block and reaches for second block?
Materials: 3 blocks without holes
Question relevant when: ${pre_cog_26} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_cog > gr_start_g_cog
Group relevant when: ( ${month_calculate_str} >6.5 and ${month_calculate_str} <9) or ${pre_cog_25} =0 or ${pre_cog_26} =0 or ${pre_cog_27} =0
generated_note_name_295 Start point G
pre_cog_22 (required) 22. Does the child play with image by looking and smiling/laughing, patting, banging, reaching playfully, or mouthing?
Materials: Mirror
1 Yes
0 No
pre_cog_23 (required) 23. Does the child play with string by picking it up, chewing it, pulling on it, or manipulating it?
Materials: Ring with string
Question relevant when: ${pre_cog_22} =1
1 Yes
0 No
pre_cog_24 (required) 24. Does the child purposely bang in play at any time during testing?
Materials: Block without hole, spoon, or other suitable hard object
Question relevant when: ${pre_cog_23} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_cog > gr_start_f_cog
Group relevant when: ( ${month_calculate_str} >5.5 and ${month_calculate_str} <=6.5) or ${pre_cog_22} =0 or ${pre_cog_23} =0 or ${pre_cog_24} =0
generated_note_name_304 Start point F
pre_cog_19 (required) 19. Does the child approach mirror image with head, body, or hands, or purposely touches mirror image? 1 Yes
0 No
pre_cog_20 (required) 20. Does the child display awareness of being in novel surroundings (e.g., startles, looks around)?
Question relevant when: ${pre_cog_19} =1
1 Yes
0 No
pre_cog_21 (required) 21. Does the child persistently reach for object, even if he or she fails to obtain it?
Materials: Block without hole or other small object of interest
Question relevant when: ${pre_cog_20} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_cog > gr_start_e_cog
Group relevant when: ( ${month_calculate_str} >4.5 and ${month_calculate_str} <=5.5) or ${pre_cog_19} =0 or ${pre_cog_20} =0 or ${pre_cog_21} =0
generated_note_name_313 Start point E
pre_cog_16 (required) 16. Does the child attend to sight, sound, or feel of object by shaking, mouthing, or other activity?
Materials: Rattle or other small object of interest
1 Yes
0 No
pre_cog_17 (required) 17. Does the child purposely carry object to mouth?
Materials: Glitter bracelet or other small object of interest
1 Yes
0 No
Field Question Answer
Question relevant when: ${pre_cog_16} =1
pre_cog_18 (required) 18. Does the child visually inspect one or both hands?
Question relevant when: ${pre_cog_17} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_cog > gr_start_d_cog
Group relevant when: ( ${month_calculate_str} >3.5 and ${month_calculate_str} <=4.5) or ${pre_cog_16} =0 or ${pre_cog_17} =0 or ${pre_cog_18} =0
generated_note_name_322 Start point D
pre_cog_7 (required) 7. Does the child display anticipatory excitement? 1 Yes
0 No
pre_cog_8 (required) 8. Does the child regard object continuously for at least 5 seconds?
Materials: Block or other small object of interest, and Stopwatch
Time: 5 seconds
Question relevant when: ${pre_cog_7} =1
1 Yes
0 No
pre_cog_9 (required) 9. Does the child change facial expression or displays other reaction to caregiver's disappearance?
Question relevant when: ${pre_cog_8} =1
1 Yes
0 No
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
29
Field Question Answer
Survey > Child Development Survey > determine_start_cog > gr_start_bc_cog
Group relevant when: ( ${month_calculate_str} >1.5 and ${month_calculate_str} <=3.5) or ${pre_cog_7} =0 or ${pre_cog_8} =0 or ${pre_cog_9} =0
generated_note_name_331 Start point B and C
pre_cog_3 (required) 3. Does the child gaze continuously at object for at least 3 seconds?
Materials: Ring with string, ball, or other small object of interest
1 Yes
0 No
pre_cog_4 (required) 4. Does the child display orienting response to stimulus, then habituates during any of the remaining trials?
Materials: Rattle
Trials: 5
Question relevant when: ${pre_cog_3} =1
1 Yes
0 No
pre_cog_5 (required) 5. Does the child respond to bell by displaying a marked behavioral change within 5 seconds after you ring bell?
Materials: Bell, and Stopwatch
Time: 5 seconds
Question relevant when: ${pre_cog_4} =1
1 Yes
0 No
generated_note_name_343 [ENUMERATOR] Please contact your supervisor. We couldn't calculate the start point. Please, reschedule the
interview with [fullname_caregiver].
Question relevant when: ${start_group_cog} = ''
generated_note_name_345 [ENUMERATOR] This child is performing below expectations for their age. If the child is distracted or not feeling well,
please take a break. Please also let your supervisor know that this child is having extreme difficulty.
Question relevant when: ${sum_passing_cog} > 2 and ${start_group_cog} != ''
failing_cog (required) Why is the child failing?
Question relevant when: ${sum_passing_cog} > 2
Response constrained to: string-length(.) > 3
Survey > Child Development Survey > (cognitive) Cognitive Scale
generated_note_name_354 Cognitive Scale
Thanks, now Im goint to start the cognitive scale.
Question relevant when: ${start_group_cog} != ''
generated_note_name_355 [ENUM]: Below, will appear some questions blocked, you have previously answered them to determine the starting
point.
Please, just click next.
Question relevant when: ${start_group_cog} != ''
generated_note_name_357 Start point A
Question relevant when: ${start_group_cog} ='A'
cog_1 (required) 1. Does the child calm when picked up by either you or caregiver?
Question relevant when: ${start_group_cog} ='A'
1 Yes
0 No
cog_2 (required) 2. Does the child freely turn eyes or head in visual exploration of surroundings?
Question relevant when: ${start_group_cog} ='A'
1 Yes
0 No
generated_note_name_360 Start point B and C
Question relevant when: ${start_group_cog} ='BC'
cog_3 (required) 3. Does the child gaze continuously at object for at least 3 seconds?
Materials: Ring with string, ball, or other small object of interest
Question relevant when: ${start_group_cog} ='A' or ${start_group_cog} ='BC'
1 Yes
0 No
cog_4 (required) 4. Does the child display orienting response to stimulus, then habituates during any of the remaining trials?
Materials: Rattle
Trials: 5
Question relevant when: ${start_group_cog} ='A' or ${start_group_cog} ='BC'
1 Yes
0 No
cog_5 (required) 5. Does the child respond to bell by displaying a marked behavioral change within 5 seconds after you ring bell?
Materials: Bell, and Stopwatch
Time: 5 seconds
Question relevant when: ${start_group_cog} ='A' or ${start_group_cog} ='BC'
1 Yes
0 No
cog_6 (required) 6. Does the child's expression changes to indicate recognition of the caregiver?
Question relevant when: ${start_group_cog} ='BC' or ( ${cog_1} + ${cog_2} + ${cog_3} + ${cog_4} + ${cog_5} )
>=1
1 Yes
0 No
generated_note_name_365 Start point D
Field Question Answer
Question relevant when: ${start_group_cog} ='D'
cog_7 (required) 7. Does the child display anticipatory excitement?
Question relevant when: ${start_group_cog} ='BC' or ${start_group_cog} ='D' or ( ${cog_2} + ${cog_3} + ${cog_4}
+ ${cog_5} + ${cog_6} ) >=1
1 Yes
0 No
cog_8 (required) 8. Does the child regard object continuously for at least 5 seconds? 1 Yes
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
30
Field Question Answer
Materials: Block or other small object of interest, and Stopwatch
Time: 5 seconds
Question relevant when: ${start_group_cog} ='D' or ( ${cog_3} + ${cog_4} + ${cog_5} + ${cog_6} + ${cog_7} ) >=1
0 No
cog_9 (required) 9. Does the child change facial expression or displays other reaction to caregiver's disappearance?
Question relevant when: ${start_group_cog} ='D' or ( ${cog_4} + ${cog_5} + ${cog_6} + ${cog_7} + ${cog_8} ) >=1
1 Yes
0 No
cog_10 (required) 10. Does the child's eyes move from one object to another in response to sound or movement of object(s)?
Materials: Bell, and Rattle
Trials: 3
Question relevant when: ${start_group_cog} ='D' or ( ${cog_5} + ${cog_6} + ${cog_7} + ${cog_8} + ${cog_9} ) >=1
1 Yes
0 No
cog_11 (required) 11. Does the child look longer at striped pattern on both pages?
Materials: Stimulus Book (pp.7-9), and Stopwatch
Time: 15 seconds per page
Question relevant when: ${start_group_cog} ='D' or ( ${cog_6} + ${cog_7} + ${cog_8} + ${cog_9} + ${cog_10} )
>=1
1 Yes
0 No
cog_12 (required) 12. Does the child habituate within 30 seconds, displaying decrease in attention and interest?
Materials: 2 blocks without holes, and Stopwatch
Time: 30 seconds
Question relevant when: ( ${cog_7} + ${cog_8} + ${cog_9} + ${cog_10} + ${cog_11} ) >=1
1 Yes
0 No
cog_13 (required) 13. Does the child look longer at ball than block in both presentations?
Materials: Block without hole, Small ball, and Stopwatch
Time: 15 seconds per presentation
Question relevant when: ( ${cog_8} + ${cog_9} + ${cog_10} + ${cog_11} + ${cog_12} ) >=1
1 Yes
0 No
cog_14 (required) 14. Does the child habituate within 30 seconds, displaying decrease in attention and interest?
Materials: Stimulus Book (p. 11), and Stopwatch
Time: 30 seconds
Question relevant when: ( ${cog_9} + ${cog_10} + ${cog_11} + ${cog_12} + ${cog_13} ) >=1
1 Yes
0 No
cog_15 (required) 15. Does the child look longer at ball than balloons in both presentations?
Materials: Stimulus Book (pp. 13-15), and Stopwatch
Time: 15 seconds per page
Question relevant when: ( ${cog_10} + ${cog_11} + ${cog_12} + ${cog_13} + ${cog_14} ) >=1
1 Yes
0 No
generated_note_name_375 Start point E
Question relevant when: ${start_group_cog} ='E'
cog_16 (required) 16. Does the child attend to sight, sound, or feel of object by shaking, mouthing, or other activity?
Materials: Rattle or other small object of interest
Question relevant when: ${start_group_cog} ='E' or ( ${cog_11} + ${cog_12} + ${cog_13} + ${cog_14} + ${cog_15}
) >=1
1 Yes
0 No
cog_17 (required) 17. Does the child purposely carry object to mouth?
Materials: Glitter bracelet or other small object of interest
Question relevant when: ${start_group_cog} ='E' or ( ${cog_12} + ${cog_13} + ${cog_14} + ${cog_15} + ${cog_16}
) >=1
1 Yes
0 No
cog_18 (required) 18. Does the child visually inspect one or both hands?
Question relevant when: ${start_group_cog} ='E' or ( ${cog_13} + ${cog_14} + ${cog_15} + ${cog_16} + ${cog_17}
) >=1
1 Yes
0 No
generated_note_name_379 Start point F
Question relevant when: ${start_group_cog} ='F'
cog_19 (required) 19. Does the child approach mirror image with head, body, or hands, or purposely touches mirror image?
Question relevant when: ${start_group_cog} ='E' or ${start_group_cog} ='F' or ( ${cog_14} + ${cog_15} +
${cog_16} + ${cog_17} + ${cog_18} ) >=1
1 Yes
0 No
cog_20 (required) 20. Does the child display awareness of being in novel surroundings (e.g., startles, looks around)?
Question relevant when: ${start_group_cog} ='E' or ${start_group_cog} ='F' or ( ${cog_15} + ${cog_16} +
${cog_17} + ${cog_18} + ${cog_19} ) >=1
1 Yes
0 No
cog_21 (required) 21. Does the child persistently reach for object, even if he or she fails to obtain it?
Materials: Block without hole or other small object of interest
Question relevant when: ${start_group_cog} ='F' or ( ${cog_16} + ${cog_17} + ${cog_18} + ${cog_19} + ${cog_20}
) >=1
1 Yes
0 No
generated_note_name_383 Start point G
Question relevant when: ${start_group_cog} ='G'
cog_22 (required) 22. Does the child play with image by looking and smiling/laughing, patting, banging, reaching playfully, or mouthing?
Materials: Mirror
Question relevant when: ${start_group_cog} ='F' or ${start_group_cog} ='G' or ( ${cog_17} + ${cog_18} +
${cog_19} + ${cog_20} + ${cog_21} ) >=1
1 Yes
0 No
cog_23 (required) 23. Does the child play with string by picking it up, chewing it, pulling on it, or manipulating it?
Materials: Ring with string
Question relevant when: ${start_group_cog} ='F' or ${start_group_cog} ='G' or ( ${cog_18} + ${cog_19} +
${cog_20} + ${cog_21} + ${cog_22} ) >=1
1 Yes
0 No
cog_24 (required) 24. Does the child purposely bang in play at any time during testing?
Materials: Block without hole, spoon, or other suitable hard object
Question relevant when: ${start_group_cog} ='G' or ( ${cog_19} + ${cog_20} + ${cog_21} + ${cog_22} +
${cog_23} ) >=1
1 Yes
0 No
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Annex E: Study Instrument
31
Field Question Answer
generated_note_name_387 Start point H
Question relevant when: ${start_group_cog} ='H'
cog_25 (required) 25. Does the child look for fallen toy by looking toward floor?
Materials: Squeeze toy
Question relevant when: ${start_group_cog} ='G' or ${start_group_cog} ='H' or ( ${cog_20} + ${cog_21} +
${cog_22} + ${cog_23} + ${cog_24} ) >=1
1 Yes
0 No
cog_26 (required) 26. Does the child manipulate bell while looking at it with interest?
Materials: Bell
Question relevant when: ${start_group_cog} ='G' or ${start_group_cog} ='H' or ( ${cog_21} + ${cog_22} +
${cog_23} + ${cog_24} + ${cog_25} ) >=1
1 Yes
0 No
cog_27 (required) 27. Does the child hold first block and reaches for second block?
Materials: 3 blocks without holes
Question relevant when: ${start_group_cog} ='H' or ( ${cog_22} + ${cog_23} + ${cog_24} + ${cog_25} + ${cog_26}
) >=1
1 Yes
0 No
cog_28 (required) 28. Does the child pull washcloth purposely toward him or her to obtain object?
Materials: Wash cloth, and Object of interest
Question relevant when: ${start_group_cog} ='H' or ( ${cog_23} + ${cog_24} + ${cog_25} + ${cog_26} + ${cog_27}
) >=1
1 Yes
0 No
cog_29 (required) 29. Does the child pick up string, purposely pulls to secure ring, and grasps ring?
Materials: Ring with string
Question relevant when: ${start_group_cog} ='H' or ( ${cog_24} + ${cog_25} + ${cog_26} + ${cog_27} + ${cog_28}
) >=1
1 Yes
0 No
cog_30 (required) 30. Does the child hold both blocks simultaneously for at least 3 seconds?
Materials: 2 blocks without holes
Question relevant when: ( ${cog_25} + ${cog_26} + ${cog_27} + ${cog_28} + ${cog_29} ) >=1
1 Yes
0 No
generated_note_name_394 Start point I
Question relevant when: ${start_group_cog} ='I'
cog_31 (required) 31. Does the child hold bell by handle and purposely rings it?
Materials: Bell
Question relevant when: ${start_group_cog} ='I' or ( ${cog_26} + ${cog_27} + ${cog_28} + ${cog_29} + ${cog_30}
) >=1
1 Yes
0 No
cog_32 (required) 32. Does the child regard one or more specific pictures with interest or recognition?
Materials: Picture Book
Question relevant when: ${start_group_cog} ='I' or ( ${cog_27} + ${cog_28} + ${cog_29} + ${cog_30} + ${cog_31}
) >=1
1 Yes
0 No
cog_33 (required) 33. Does the child retain first two blocks for at least 3 seconds after visually attending to third block?
Materials: 3 blocks without holes
Question relevant when: ${start_group_cog} ='I' or ( ${cog_28} + ${cog_29} + ${cog_30} + ${cog_31} + ${cog_32}
) >=1
1 Yes
0 No
generated_note_name_398 Start point J
Question relevant when: ${start_group_cog} ='J'
cog_34 (required) 34. Does the child look into empty cup for blocks?
Materials: 3 blocks without holes, and Cup with handle.
Trials: 2
Question relevant when: ${start_group_cog} ='I' or ${start_group_cog} ='J' or ( ${cog_29} + ${cog_30} + ${cog_31}
+ ${cog_32} + ${cog_33} ) >=1
1 Yes
0 No
cog_35 (required) 35. Does the child take all three blocks out of cup?
Materials: 3 blocks without holes, Cup with handle, and Stopwatch.
Time: 2 minutes
Question relevant when: ${start_group_cog} ='I' or ${start_group_cog} ='J' or ( ${cog_30} + ${cog_31} + ${cog_32}
+ ${cog_33} + ${cog_34} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_36
Group relevant when: ${start_group_cog} ='J' or ( ${cog_31} + ${cog_32} + ${cog_33} + ${cog_34} + ${cog_35} ) >=1
cog_36 (required) 36. Does the child place at least one block in or over cup, even if he or she does not release it?
Materials: 9 blocks, and Cup with handle.
Question relevant when: ${pre_cog_36} != null
1 Yes
0 No
cog_36a (36a) Number of blocks in cup:
Question relevant when: ${pre_cog_36a} != null
cog_37 (required) 37. Does the child retain first two blocks in one or both hands and attempts to secure third block?
Materials: 3 blocks without holes
Question relevant when: ${start_group_cog} ='J' or ( ${cog_32} + ${cog_33} + ${cog_34} + ${cog_35} + ${cog_36}
) >=1
1 Yes
0 No
cog_38 (required) 38. Does the child intentionally poke finger into at least one hole?
Materials: Pegboard
1 Yes
0 No
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
32
Field Question Answer
Question relevant when: ${start_group_cog} ='J' or ( ${cog_33} + ${cog_34} + ${cog_35} + ${cog_36} + ${cog_37}
) >=1
cog_39 (required) 39. Does the child intentionally pushe car so that all four wheels stay on table?
Materials: Car
Question relevant when: ( ${cog_34} + ${cog_35} + ${cog_36} + ${cog_37} + ${cog_38} ) >=1
1 Yes
0 No
generated_note_name_409 Start point K
Field Question Answer
Question relevant when: ${start_group_cog} ='K'
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_40
Group relevant when: ${start_group_cog} ='K' or ( ${cog_35} + ${cog_36} + ${cog_37} + ${cog_38} + ${cog_39} ) >=1
cog_40 (required) 40. Does the child find bracelet by looking first under correct washcloth when hidden on both left and right sides?
Materials: Glitter bracelet, and 2 washcloths
Trials: 2
Question relevant when: ${pre_cog_40} != null
1 Yes
0 No
cog_item_40_1 Trial 1:
Question relevant when: ${pre_cog_item_40_1} != null
1 Right
2 Left
cog_item_40_2 Trial 2:
Question relevant when: ${pre_cog_item_40_2} != null
1 Right
2 Left
cog_41 (required) 41. Does the child obtain ring and suspends it by string without the ring touching the table?
Materials: Ring with string
Question relevant when: ${start_group_cog} ='K' or ( ${cog_36} + ${cog_37} + ${cog_38} + ${cog_39} + ${cog_40}
) >=1
1 Yes
0 No
cog_42 (required) 42. Does the child purposely remove uncooked bean from bottle using some form of directed effort?
Materials: Uncooked beans, and Bottle (without lid)
Trials: 3
Question relevant when: ${start_group_cog} ='K' or ( ${cog_37} + ${cog_38} + ${cog_39} + ${cog_40} + ${cog_41}
) >=1
1 Yes
0 No
cog_43 (required) 43. Does the child retrieve object through open end of box within 20 seconds?
Materials: Clear box, Small object of interest, and Stopwatch
Time: 20 seconds
Question relevant when: ${start_group_cog} ='K' or ( ${cog_38} + ${cog_39} + ${cog_40} + ${cog_41} + ${cog_42}
) >=1
1 Yes
0 No
cog_44 (required) 44. Does the child attempt to squeeze toy to make the sound?
Materials: Squeeze toy
Question relevant when: ${start_group_cog} ='K' or ( ${cog_39} + ${cog_40} + ${cog_41} + ${cog_42} + ${cog_43}
) >=1
1 Yes
0 No
generated_note_name_419 Start point L and M
Question relevant when: ${start_group_cog} ='LM'
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_45
Group relevant when: ${start_group_cog} ='LM' or ( ${cog_40} + ${cog_41} + ${cog_42} + ${cog_43} + ${cog_44} ) >=1
cog_45 (required) 45. Does the child find bracelet by looking first under correct washcloth when hidden on both left and right sides?
Materials: Glitter bracelet, and 2 washcloths
Trials: 2
Question relevant when: ${pre_cog_45} != null
1 Yes
0 No
cog_item_45_1 Trial 1:
Question relevant when: ${pre_cog_item_45_1} != null
1 Right
2 Left
cog_item_45_2 Trial 2:
Question relevant when: ${pre_cog_item_45_2} != null
1 Right
2 Left
cog_46 (required) 46. Does the child unscrew lid until it comes off?
Materials: Bottle with lid
Question relevant when: ${start_group_cog} ='LM' or ( ${cog_41} + ${cog_42} + ${cog_43} + ${cog_44} +
${cog_45} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_47
Group relevant when: ${start_group_cog} ='LM' or ( ${cog_42} + ${cog_43} + ${cog_44} + ${cog_45} + ${cog_46} ) >=1
cog_47 (required) 47. Does the child place at least one peg two or more times in the same or different hole(s)?
Materials: Pegboard, 6 yellow pegs, and Stopwatch.
Time: 70 seconds per trial
Trials:
3
Question relevant when: ${pre_cog_47} != null
1 Yes
0 No
cog_47a (47a) Trial 1 Completion time (all 6 pegs):
Question relevant when: ${pre_cog_47a} != null
cog_47b (47b) Trial 2 Completion time (all 6 pegs):
Question relevant when: ${pre_cog_47b} != null
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Annex E: Study Instrument
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Field Question Answer
cog_47c (47c) Trial 3 Completion time (all 6 pegs):
Question relevant when: ${pre_cog_47c} != null
cog_48 (required) 48. Does the child demonstrate relational play using him-or herself?
Materials: Doll, Bear, Plastic cups Spoons, Small ball, Washcloths, and Several blocks
Question relevant when: ${start_group_cog} ='LM' or ( ${cog_43} + ${cog_44} + ${cog_45} + ${cog_46} +
${cog_47} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_49
Group relevant when: ${start_group_cog} ='LM' or ( ${cog_44} + ${cog_45} + ${cog_46} + ${cog_47} + ${cog_48} ) >=1
cog_49 (required) 49. Does the child correctly place at least one piece within 180 seconds?
Materials: Pink board, Red block set (square, circle, triangle), and Stopwatch
Time: 180 seconds
1 Yes
0 No
cog_49a (49a) # pieces placed correctly (in 180 seconds):
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_50
Group relevant when: ( ${cog_45} + ${cog_46} + ${cog_47} + ${cog_48} + ${cog_49} ) >=1
cog_50 (required) 50. Does the child find bracelet by looking first under correct washcloth when hidden on both left and right sides?
Materials: Glitter bracelet, and 2 washcloths
Trials: 2
1 Yes
Field Question Answer
0 No
cog_item_50_1 Trial 1: 1 Right
2 Left
cog_item_50_2 Trial 2: 1 Right
2 Left
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_51
Group relevant when: ( ${cog_46} + ${cog_47} + ${cog_48} + ${cog_49} + ${cog_50} ) >=1
cog_51 (required) 51. Does the child correctly place at least one piece within 150 seconds?
Materials: Blue board, Blue block set (4 round, 5 square), and Stopwatch
Time: 150 seconds
1 Yes
0 No
cog_51a (51a) Completion time:
cog_51b (51b) # of pieces:
cog_52 (required) 52. Does the child retrieve object through open end of box when presented on both left and right sides?
Materials: Clear box, Small object of interest, and Stopwatch
Time: 20 seconds per side
Question relevant when: ( ${cog_47} + ${cog_48} + ${cog_49} + ${cog_50} + ${cog_51} ) >=1
1 Yes
0 No
cog_53 (required) 53. Does the child demonstrate relational play, using objects for how they are intended, with others?
Materials: Doll, Bear, Plastic cups, Spoons, Small ball, Washcloths, and Several blocks
Question relevant when: ( ${cog_48} + ${cog_49} + ${cog_50} + ${cog_51} + ${cog_52} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_54
Group relevant when: ( ${cog_49} + ${cog_50} + ${cog_51} + ${cog_52} + ${cog_53} ) >=1
cog_54 (required) 54. Does the child place all nine blocks inside cup at one time?
Materials: 9 blocks, and Cup with handle
1 Yes
0 No
cog_54a (54a) # of blocks in cup:
Response constrained to: . <= 9
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_55
Group relevant when: ( ${cog_50} + ${cog_51} + ${cog_52} + ${cog_53} + ${cog_54} ) >=1
cog_55 (required) 55. Does the child place all six pegs in pegboard within 70 seconds?
Materials: Pegboard, 6 yellow pegs, and Stopwatch
Time: 70 seconds
Trials: 3
1 Yes
0 No
cog_55a (55a) Trial 1 Completion time (all 6 pegs):
cog_55b (55b) Trial 2 Completion time (all 6 pegs):
cog_55c (55c) Trial 3 Completion time (all 6 pegs):
generated_note_name_459 Start point N
Question relevant when: ${start_group_cog} ='N'
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_56
Group relevant when: ${start_group_cog} ='N' or ( ${cog_51} + ${cog_52} + ${cog_53} + ${cog_54} + ${cog_55} ) >=1
cog_56 (required) 56. Does the child correctly place all three pieces within 180 seconds?
Materials: Pink board, Red block set (square, circle, triangle), and Stopwatch
Time: 180 seconds
Question relevant when: ${pre_cog_56} != null
1 Yes
0 No
cog_56a (56a) # pieces placed correctly (180 seconds):
Question relevant when: ${pre_cog_56a} != null
Response constrained to: . <= 3
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Annex E: Study Instrument
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Field Question Answer
cog_57 (required) 57. Does the child use pencil to attempt to obtain duck?
Materials: Pencil, and Small red duck
Trials: 2
Question relevant when: ${start_group_cog} ='N' or ( ${cog_52} + ${cog_53} + ${cog_54} + ${cog_55} + ${cog_56}
) >=1
1 Yes
0 No
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_58
Group relevant when: ${start_group_cog} ='N' or ( ${cog_53} + ${cog_54} + ${cog_55} + ${cog_56} + ${cog_57} ) >=1
cog_58 (required) 58. Does the child correctly place at least four pieces within 150 seconds?
Materials: Blue board Blue block set (4 round, 5 square), and Stopwatch
Time: 150 seconds
Question relevant when: ${pre_cog_58} != null
1 Yes
0 No
cog_58a (58a) Completion time:
Question relevant when: ${pre_cog_58a} != null
cog_58b (58b) # of pieces:
Question relevant when: ${pre_cog_58b} != null
cog_59 (required) 59. Does the child attend to entire story?
Materials: Story Book
Question relevant when: ${start_group_cog} ='N' or ( ${cog_54} + ${cog_55} + ${cog_56} + ${cog_57} + ${cog_58}
) >=1
1 Yes
0 No
generated_note_name_471 Start point O
Question relevant when: ${start_group_cog} ='O'
cog_60 (required) 60. Does the child correctly place all three pieces while board is in rotated position?
Materials: Pink board, and Red block set (square, circle, triangle)
Question relevant when: ${start_group_cog} ='N' or ${start_group_cog} ='O' or ( ${cog_55} + ${cog_56} +
${cog_57} + ${cog_58} + ${cog_59} ) >=1
1 Yes
0 No
cog_61 (required) 61. Does the child correctly assemble object within 90 seconds in either trial? 1 Yes
Field Question Answer
Materials: Ball puzzle, and Stopwatch
Time: 90 seconds
Trials: 2
Question relevant when: ${start_group_cog} ='O' or ( ${cog_56} + ${cog_57} + ${cog_58} + ${cog_59} +
${cog_60} ) >=1
0 No
cog_62 (required) 62. Does the child place all six pegs in pegboard within 25 seconds?
Materials: Pegboard, 6 yellow pegs, and Stopwatch
Time: 25 seconds
Question relevant when: ${start_group_cog} ='O' or ( ${cog_57} + ${cog_58} + ${cog_59} + ${cog_60} +
${cog_61} ) >=1
1 Yes
0 No
generated_note_name_475 Start point P
Question relevant when: ${start_group_cog} ='P'
cog_63 (required) 63. Does the child correctly assemble object within 90 seconds , in either trial?
Materials: Ice cream cone puzzle and Stopwatch.
Time: 90 seconds
Trials: 2
Question relevant when: ${start_group_cog} ='O' or ${start_group_cog} ='P' or ( ${cog_58} + ${cog_59} +
${cog_60} + ${cog_61} + ${cog_62} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_64
Group relevant when: ${start_group_cog} ='O' or ${start_group_cog} ='P' or ( ${cog_59} + ${cog_60} + ${cog_61} + ${cog_62} + ${cog_63} ) >=1
note_cog_64 64. Does the child correctly identify matching picture n at least three pages?
Materials: Stimulus Book (pp.17-23)
1 Yes
0 No
cog_item_64_1 (required) Bus?
Question relevant when: ${pre_cog_item_64_1} != null
1 Yes
0 No
cog_item_64_2 (required) Bicycle?
Question relevant when: ${pre_cog_item_64_2} != null
1 Yes
0 No
cog_item_64_3 (required) Tree?
Question relevant when: ${pre_cog_item_64_3} != null
1 Yes
0 No
cog_item_64_4 (required) Telephone?
Question relevant when: ${pre_cog_item_64_4} != null
1 Yes
0 No
cog_65 (required) 65. Does the child take an object and pretends it is something else?
Materials: Plastic cups, Spoon, Doll, Washcloths, Block, and Other objects of interest
Question relevant when: ${start_group_cog} ='P' or ( ${cog_60} + ${cog_61} + ${cog_62} + ${cog_63} + ${cog_64}
) >=1
1 Yes
0 No
cog_66 (required) 66. Does the child correctly place all nine pieces within 75 seconds?
Materials: Blue board, Blue block set (4 round, 5 square), and Stopwatch
Time: 75 seconds
Question relevant when: ${start_group_cog} ='P' or ( ${cog_61} + ${cog_62} + ${cog_63} + ${cog_64} + ${cog_65}
) >=1
1 Yes
0 No
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
35
Field Question Answer
generated_note_name_487 Start point Q
Question relevant when: ${start_group_cog} ='Q'
cog_67 (required) 67. Does the child correctly imitate both steps?
Materials: Small yellow duck, and Spoon
Trials: 3
Question relevant when: ${start_group_cog} ='P' or ${start_group_cog} ='Q' or ( ${cog_62} + ${cog_63} +
${cog_64} + ${cog_65} + ${cog_66} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_68
Group relevant when: ${start_group_cog} ='Q' or ( ${cog_63} + ${cog_64} + ${cog_65} + ${cog_66} + ${cog_67} ) >=1
note_cog_68 68. Does the child place yellow, blue, and green disks on or near matching crayons in Stimulus Book, or point to
matching crayons?
Materials: Stimulus Book (p.25), Red, yellow, blue, and green disks.
1 Yes
0 No
cog_item_68_1 (required) Yellow?
Question relevant when: ${pre_cog_item_68_1} != null
1 Yes
0 No
cog_item_68_2 (required) Blue?
Question relevant when: ${pre_cog_item_68_2} != null
1 Yes
0 No
cog_item_68_3 (required) Green?
Question relevant when: ${pre_cog_item_68_3} != null
1 Yes
0 No
cog_69 (required) 69. Does the child use imaginary objects in play?
Materials: Plastic cups, Spoon
Doll, Bear, Washcloths, Small ball, and Other objects of interest
Question relevant when: ${start_group_cog} ='Q' or ( ${cog_64} + ${cog_65} + ${cog_66} + ${cog_67} +
${cog_68} ) >=1
1 Yes
0 No
cog_70 (required) 70. Does the child hand you only one block within 5 seconds?
Materials: 3 blocks without holes, and Stopwatch
Time: 5 seconds
Question relevant when: ${start_group_cog} ='Q' or ( ${cog_65} + ${cog_66} + ${cog_67} + ${cog_68} +
${cog_69} ) >=1
1 Yes
0 No
cog_71 (required) 71. Does the child demonstrate multischeme combination play involving at least two steps?
Materials: Plastic cups Spoon, Doll, Bear, Washcloths, Small ball, and Other objects of interest
Question relevant when: ${start_group_cog} ='Q' or ( ${cog_66} + ${cog_67} + ${cog_68} + ${cog_69} +
${cog_70} ) >=1
1 Yes
0 No
cog_72 (required) 72. Does the child correctly identify both blue ducks?
Materials: Big and little ducks (blue and yellow)
Question relevant when: ( ${cog_67} + ${cog_68} + ${cog_69} + ${cog_70} + ${cog_71} ) >=1
1 Yes
0 No
Field Question Answer
cog_73 (required) 73. Does the child correctly identify both little ducks and both big ducks?
Materials: Big and little ducks (red and yellow)
Question relevant when: ( ${cog_68} + ${cog_69} + ${cog_70} + ${cog_71} + ${cog_72} ) >=1
1 Yes
0 No
cog_74 (required) 74. Does the child correctly identify heavy duck when placed in both left and right hands?
Materials: 2 big blue ducks
Trials: 2
Question relevant when: ( ${cog_69} + ${cog_70} + ${cog_71} + ${cog_72} + ${cog_73} ) >=1
1 Yes
0 No
cog_75 (required) 75. Does the child correctly identify big blue duck?
Materials: Big red duck, Big blue duck, and Little yellow duck
Question relevant when: ( ${cog_70} + ${cog_71} + ${cog_72} + ${cog_73} + ${cog_74} ) >=1
1 Yes
0 No
cog_76 (required) 76. Does the child correctly identify calf and donkey?
Materials: Stimulus Book (pp.27-37)
Question relevant when: ( ${cog_71} + ${cog_72} + ${cog_73} + ${cog_74} + ${cog_75} ) >=1
1 Yes
0 No
cog_77 (required) 77. Does the child correctly identify big yellow duck?
Materials: Big and little ducks
Question relevant when: ( ${cog_72} + ${cog_73} + ${cog_74} + ${cog_75} + ${cog_76} ) >=1
1 Yes
0 No
cog_78 (required) 78. Does the child sort pegs by color, placing them in appropriate cups or in separate piles?
Materials: 4 red pegs, 4 yellow pegs, 4 blue pegs, and 3 plastic cups
Question relevant when: ( ${cog_73} + ${cog_74} + ${cog_75} + ${cog_76} + ${cog_77} ) >=1
1 Yes
0 No
cog_79 (required) 79. Does the child assign only one number to each block when counting, child must count to at least 3 in proper
sequence?
Materials: 5 blocks
Question relevant when: ( ${cog_74} + ${cog_75} + ${cog_76} + ${cog_77} + ${cog_78} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_80
Group relevant when: ( ${cog_75} + ${cog_76} + ${cog_77} + ${cog_78} + ${cog_79} ) >=1
note_cog_80 80. Does the child identify correctly-sized object for at least two of three pages?
Materials: Stimulus Book (pp.39-43)
1 Yes
0 No
cog_item_80_1 (required) Box lid? 1 Yes
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
36
Field Question Answer
0 No
cog_item_80_2 (required) Bowl? 1 Yes
0 No
cog_item_80_3 (required) Shoe? 1 Yes
0 No
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_81
Group relevant when: ( ${cog_76} + ${cog_77} + ${cog_78} + ${cog_79} + ${cog_80} ) >=1
note_cog_81 81. For all three series, does the child correctly identify image when presented with first or second page of the series?
Materials: Stimulus Book (pp.45-61)
1 Yes
0 No
cog_item_81_1 (required) Face 1 Yes
0 No
cog_item_81_2 (required) Cat 1 Yes
0 No
cog_item_81_3 (required) Flower 1 Yes
0 No
cog_82 (required) 82. Does the child correctly assemble object within 90 seconds in either trial?
Materials: Dog puzzle, and Stopwatch
Time: 90 seconds
Trials: 2
Question relevant when: ( ${cog_77} + ${cog_78} + ${cog_79} + ${cog_80} + ${cog_81} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_83
Group relevant when: ( ${cog_78} + ${cog_79} + ${cog_80} + ${cog_81} + ${cog_82} ) >=1
note_cog_83 83. Does the child correctly identify out-of-place object?
Materials: Stimulus Book (pp.63-67)
1 Yes
0 No
cog_item_83_1 (required) Square? 1 Yes
0 No
cog_item_83_2 (required) Triangle? 1 Yes
0 No
cog_item_83_3 (required) E? 1 Yes
0 No
cog_84 (required) 84. Does the child correctly identify the correct pairs of soccer ball for the first two objects?
Materials: Soccer ball
Question relevant when: ( ${cog_79} + ${cog_80} + ${cog_81} + ${cog_82} + ${cog_83} ) >=1
1 Yes
0 No
cog_85 (required) 85. Does the child correctly respond to both parts?
Materials: 10 blocks
Question relevant when: ( ${cog_80} + ${cog_81} + ${cog_82} + ${cog_83} + ${cog_84} ) >=1
1 Yes
0 No
cog_86 (required) 86. Does the child correctly answer both questions?
Materials: 5 blocks
Question relevant when: ( ${cog_81} + ${cog_82} + ${cog_83} + ${cog_84} + ${cog_85} ) >=1
1 Yes
0 No
Field Question Answer
cog_87 (required) 87. Does the child lace shoelace through entire lacing card, in proper order without skipping holes or lacing around
side of card?
Materials: Lacing card, and Shoelace
Question relevant when: ( ${cog_82} + ${cog_83} + ${cog_84} + ${cog_85} + ${cog_86} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_88
Group relevant when: ( ${cog_83} + ${cog_84} + ${cog_85} + ${cog_86} + ${cog_87} ) >=1
note_cog_88 88. Does the child correctly identify the object that don't belong?
Materials: Stimulus Book (pp.69-73)
1 Yes
0 No
cog_item_88_1 (required) Tree? 1 Yes
0 No
cog_item_88_2 (required) Water bottle? 1 Yes
0 No
cog_item_88_3 (required) Bus? 1 Yes
0 No
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_89
Group relevant when: ( ${cog_84} + ${cog_85} + ${cog_86} + ${cog_87} + ${cog_88} ) >=1
note_cog_89 89. Does the child understand the concept of "More"? 1 Yes
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Field Question Answer
Materials: 9 blocks, 1 red disc, and 3 red pegs 0 No
cog_item_89_1 (required) First administrations: 1 Yes
0 No
cog_item_89_2 (required) Second administrations: 1 Yes
0 No
cog_item_89_3 (required) Third administrations: 1 Yes
0 No
cog_item_89_4 (required) Fourth administrations: 1 Yes
0 No
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_90
Group relevant when: ( ${cog_85} + ${cog_86} + ${cog_87} + ${cog_88} + ${cog_89} ) >=1
note_cog_90 90. Does the child correctly repeat the number sequences? 1 Yes
0 No
cog_item_90_1 (required) A: 4-2-5 1 Yes
0 No
cog_item_90_2 (required) B: 3-1-4-2 1 Yes
0 No
cog_item_90_3 (required) C: 7-9-1-3 1 Yes
0 No
cog_item_90_4 (required) D: 5-3-7-1-6 1 Yes
0 No
cog_item_90_5 (required) E: 8-1-9-6-4 1 Yes
0 No
Survey > Child Development Survey > (cognitive) Cognitive Scale > gr_cog_91
Group relevant when: ( ${cog_86} + ${cog_87} + ${cog_88} + ${cog_89} + ${cog_90} ) >=1
note_cog_91 91. Does the child place correct pegs in pegboard?
Materials: Pegboard, and Red, blue, and yellow pegs
1 Yes
0 No
cog_item_91_1 (required) Pattern 1: R-B-R-B-R-B 1 Yes
0 No
cog_item_91_2 (required) Pattern 2: Y-B-R-Y-B-R 1 Yes
0 No
cog_item_91_3 (required) Pattern 3: Y-Y-B-Y-Y-B 1 Yes
0 No
Survey > Child Development Survey > determine_start_lrec
Group relevant when: ${start_group_cog} != ''
generated_note_name_575 We have finished with the Cognitive Subset.
Now, I'm going to ask you a couple of questions to determine where we should start the the Receptive Communication
Subtest.
Survey > Child Development Survey > determine_start_lrec > gr_start_q_lrec
Group relevant when: ${month_calculate_str} >=39
generated_note_name_578 Start point Q
pre_lrec_28 (required) 28. Does the child correctly identify at least three objects you name?
Materials: Stimulus Book (p.81)
1 Yes
Field Question Answer
0 No
Survey > Child Development Survey > determine_start_lrec > gr_start_q_lrec > pre_gr_lrec_29
Group relevant when: ${pre_lrec_28} =1
note_pre_lrec_29 29. Does the child correctly identify the pictures…?
Materials: Picture Book (pp.6- 9)
1 Yes
0 No
pre_lrec_item_29_1 (required) Waving 1 Yes
0 No
pre_lrec_item_29_2 (required) Sleeping 1 Yes
0 No
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Field Question Answer
pre_lrec_item_29_3 (required) Drinking 1 Yes
0 No
pre_lrec_item_29_4 (required) Washing 1 Yes
0 No
pre_lrec_item_29_5 (required) Riding 1 Yes
0 No
pre_lrec_item_29_6 (required) Eating 1 Yes
0 No
pre_lrec_item_29_7 (required) Reading 1 Yes
0 No
pre_lrec_item_29_8 (required) Running 1 Yes
0 No
Survey > Child Development Survey > determine_start_lrec > gr_start_q_lrec > pre_gr_lrec_30
Group relevant when: ${pre_lrec_29} =1
note_pre_lrec_30 30. Does the child correctly respond to directions, understanding the pronouns …?
Materials: Bear, 3 plastic cups, and 3 spoons
1 Yes
0 No
pre_lrec_item_30_1 (required) Him 1 Yes
0 No
pre_lrec_item_30_2 (required) Me 1 Yes
0 No
pre_lrec_item_30_3 (required) My 1 Yes
0 No
pre_lrec_item_30_4 (required) You 1 Yes
0 No
pre_lrec_item_30_5 (required) Your 1 Yes
0 No
Survey > Child Development Survey > determine_start_lrec > gr_start_p_lrec
Group relevant when: ( ${month_calculate_str} >=33 and ${month_calculate_str} <39) or ${pre_lrec_28} =0 or ${pre_lrec_29} =0 or ${pre_lrec_30} =0
generated_note_name_606 Start point P
pre_lrec_25 (required) 25. Does the child correctly follow at least one two-part direction in its entirety?
Materials: 3 objects of interest
1 Yes
0 No
Survey > Child Development Survey > determine_start_lrec > gr_start_p_lrec > pre_gr_lrec_26
Group relevant when: ${pre_lrec_25} =1
note_pre_lrec_26 26. Does the child correctly identify the pictures …?
Materials: Picture Book (pp. 6-9)
1 Yes
0 No
pre_lrec_item_26_1 (required) Waving 1 Yes
0 No
pre_lrec_item_26_2 (required) Sleeping 1 Yes
0 No
pre_lrec_item_26_3 (required) Drinking 1 Yes
0 No
pre_lrec_item_26_4 (required) Washing 1 Yes
0 No
pre_lrec_item_26_5 (required) Riding 1 Yes
0 No
pre_lrec_item_26_6 (required) Eating 1 Yes
0 No
pre_lrec_item_26_7 (required) Reading 1 Yes
0 No
pre_lrec_item_26_8 (required) Running 1 Yes
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Field Question Answer
0 No
Survey > Child Development Survey > determine_start_lrec > gr_start_p_lrec > pre_gr_lrec_27
Group relevant when: ${pre_lrec_26} =1
note_pre_lrec_27 27. Does the child correctly identify the pictures …?
Materials: Stimulus Book (p. 79)
1 Yes
0 No
pre_lrec_item_27_1 (required) Tricycie 1 Yes
0 No
pre_lrec_item_27_2 (required) Scissors 1 Yes
0 No
pre_lrec_item_27_3 (required) Shoe 1 Yes
0 No
pre_lrec_item_27_4 (required) Pot 1 Yes
0 No
pre_lrec_item_27_5 (required) Crayon 1 Yes
0 No
pre_lrec_item_27_6 (required) Glass 1 Yes
0 No
Survey > Child Development Survey > determine_start_lrec > gr_start_o_lrec
Group relevant when: ( ${month_calculate_str} >28.5 and ${month_calculate_str} <33) or ${pre_lrec_25} =0 or ${pre_lrec_26} =0 or ${pre_lrec_27} =0
generated_note_name_635 Start point O
pre_lrec_22 (required) 22. Does the child correctly identify at least three clothing items? 1 Yes
0 No
Survey > Child Development Survey > determine_start_lrec > gr_start_o_lrec > pre_gr_lrec_23
Group relevant when: ${pre_lrec_22} =1
note_pre_lrec_23 23. Does the child correctly identify the pictures…?
Materials: Picture Book (pp. 6-9)
1 Yes
0 No
pre_lrec_item_23_1 (required) Waving 1 Yes
0 No
pre_lrec_item_23_2 (required) Sleeping 1 Yes
0 No
pre_lrec_item_23_3 (required) Drinking 1 Yes
0 No
pre_lrec_item_23_4 (required) Washing 1 Yes
0 No
pre_lrec_item_23_5 (required) Riding 1 Yes
0 No
pre_lrec_item_23_6 (required) Eating 1 Yes
0 No
pre_lrec_item_23_7 (required) Reading 1 Yes
0 No
pre_lrec_item_23_8 (required) Running 1 Yes
0 No
pre_lrec_24 (required) 24. Does the child correctly point to at least five body parts?
Materials: Doll
Question relevant when: ${pre_lrec_23} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_lrec > gr_start_n_lrec
Group relevant when: ( ${month_calculate_str} >25.5 and ${month_calculate_str} <=28.5) or ${pre_lrec_22} =0 or ${pre_lrec_23} =0 or ${pre_lrec_24} =0
generated_note_name_655 Start point N
Survey > Child Development Survey > determine_start_lrec > gr_start_n_lrec > pre_gr_lrec_19
note_pre_lrec_19 19. Does the child correctly identify the objects…?
Materials: Story Book, Plastic cup, Spoon, Small ball, and Doll
1 Yes
0 No
pre_lrec_item_19_1 (required) Book 1 Yes
0 No
pre_lrec_item_19_2 (required) Spoon 1 Yes
0 No
pre_lrec_item_19_3 (required) Doll 1 Yes
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Field Question Answer
0 No
pre_lrec_item_19_4 (required) Cup 1 Yes
0 No
pre_lrec_item_19_5 (required) Ball 1 Yes
Field Question Answer
0 No
pre_lrec_20 (required) 20. Does the child correctly respond to at least two directions with the doll or bear?
Materials: Doll or bear, Spoon, Comb, and Facial tissue
Question relevant when: ${pre_lrec_19} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_lrec > gr_start_n_lrec > pre_gr_lrec_21
Group relevant when: ${pre_lrec_20} =1
note_pre_lrec_21 21. Does the child correctly identify the [item] pictures…?
Materials: Picture Book (pp.1-5)
1 Yes
0 No
pre_lrec_item_21_1 (required) Biscuit 1 Yes
0 No
pre_lrec_item_21_2 (required) Shoe(s) 1 Yes
0 No
pre_lrec_item_21_3 (required) Car 1 Yes
0 No
pre_lrec_item_21_4 (required) Balloon(s) 1 Yes
0 No
pre_lrec_item_21_5 (required) Bird 1 Yes
0 No
pre_lrec_item_21_6 (required) Bed 1 Yes
0 No
pre_lrec_item_21_7 (required) Kitten 1 Yes
0 No
pre_lrec_item_21_8 (required) Spoon 1 Yes
0 No
pre_lrec_item_21_9 (required) Ball 1 Yes
0 No
pre_lrec_item_21_10 (required) Book 1 Yes
0 No
pre_lrec_item_21_11 (required) Cup 1 Yes
0 No
pre_lrec_item_21_12 (required) Banana 1 Yes
0 No
Survey > Child Development Survey > determine_start_lrec > gr_start_m_lrec
Group relevant when: ( ${month_calculate_str} >16.5 and ${month_calculate_str} <=25.5) or ${pre_lrec_19} =0 or ${pre_lrec_20} =0 or ${pre_lrec_21} =0
generated_note_name_687 Start point M and (item 15 KL)
Survey > Child Development Survey > determine_start_lrec > gr_start_m_lrec > pre_gr_lrec_15
note_pre_lrec_15 15. Does the child correctly identify the following objects…?
Materials: Story Book, Plastic cup, Spoon, Small ball, and Doll
1 Yes
0 No
pre_lrec_item_15_1 (required) Book 1 Yes
0 No
pre_lrec_item_15_2 (required) Spoon 1 Yes
0 No
pre_lrec_item_15_3 (required) Doll 1 Yes
0 No
pre_lrec_item_15_4 (required) Cup 1 Yes
0 No
pre_lrec_item_15_5 (required) Ball 1 Yes
0 No
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Field Question Answer
pre_lrec_16 (required) 16. Does the child correctly identify the object you name?
Question relevant when: ${pre_lrec_15} =1 and ${month_calculate_str} >22.5
1 Yes
0 No
Survey > Child Development Survey > determine_start_lrec > gr_start_m_lrec > pre_gr_lrec_17
Group relevant when: ${pre_lrec_16} =1 and ${month_calculate_str} >22.5
note_pre_lrec_17 17. Does the child correctly identify the [item] pictures…?
Materials: Picture Book (pp.1-5)
1 Yes
0 No
pre_lrec_item_17_1 (required) Biscuit 1 Yes
0 No
pre_lrec_item_17_2 (required) Shoe(s) 1 Yes
0 No
pre_lrec_item_17_3 (required) Car 1 Yes
Field Question Answer
0 No
pre_lrec_item_17_4 (required) Balloon(s) 1 Yes
0 No
pre_lrec_item_17_5 (required) Bird 1 Yes
0 No
pre_lrec_item_17_6 (required) Bed 1 Yes
0 No
pre_lrec_item_17_7 (required) Kitten 1 Yes
0 No
pre_lrec_item_17_8 (required) Spoon 1 Yes
0 No
pre_lrec_item_17_9 (required) Ball 1 Yes
0 No
pre_lrec_item_17_10 (required) Book 1 Yes
0 No
pre_lrec_item_17_11 (required) Cup 1 Yes
0 No
pre_lrec_item_17_12 (required) Banana 1 Yes
0 No
Survey > Child Development Survey > determine_start_lrec > gr_start_kl_lrec
Group relevant when: ( ${month_calculate_str} >16.5 and ${month_calculate_str} <=22.5) or ${pre_lrec_16} =0 or ${pre_lrec_17} =0
generated_note_name_719 Start point K and L
pre_lrec_13 (required) 13. Does the child maintain attention and enjoys interacting with you in a play routine for at least 60 seconds?
Materials: Stopwatch
Time: 60 seconds
Question relevant when: ${pre_lrec_15} =1
1 Yes
0 No
pre_lrec_14 (required) 14.Does the child respond in an appropriate manner to at least one spoken request?
Question relevant when: ${pre_lrec_13} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_lrec > gr_start_j_lrec
Group relevant when: ( ${month_calculate_str} >=11 and ${month_calculate_str} <=16.5) or ${pre_lrec_13} =0 or ${pre_lrec_14} =0 or ${pre_lrec_15} =0
generated_note_name_727 Start point J
pre_lrec_10 (required) 10. Does the child look up and briefly pauses during play when you call his or her name?
Materials: Object of interest
1 Yes
0 No
pre_lrec_11 (required) 11. Does the child respond differentially to at least two familiar words?
Question relevant when: ${pre_lrec_10} =1 and ${month_calculate_str} >13.5
1 Yes
0 No
pre_lrec_12 (required) 12. Does the child stop reaching for object in response to no-no?
Materials: Object of interest
Question relevant when: ${pre_lrec_11} =1 and ${month_calculate_str} >13.5
1 Yes
0 No
Survey > Child Development Survey > determine_start_lrec > gr_start_i_lrec
Group relevant when: ( ${month_calculate_str} > 5.5 and ${month_calculate_str} <=13.5) or ${pre_lrec_11} =0 or ${pre_lrec_12} =0
generated_note_name_736 Start point I
pre_lrec_8 (required) 8. Does the child interact with objects for at least 60 seconds? 1 Yes
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Annex E: Study Instrument
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Field Question Answer
Materials: Objects of interest, and Stopwatch
Time:60 seconds
Question relevant when: ${pre_lrec_10} =1
0 No
pre_lrec_9 (required) 9. Does the child turn head both times his or her name is called, but does not respond to unfamiliar name?
Question relevant when: ${pre_lrec_8} =1 and ${month_calculate_str} >=11
1 Yes
0 No
Survey > Child Development Survey > determine_start_lrec > gr_start_fgh_lrec
Group relevant when: ( ${month_calculate_str} > 5.5 and ${month_calculate_str} < 11) or ${pre_lrec_9} =0 or ${pre_lrec_10} =0
generated_note_name_744 Start point F, G, and H
pre_lrec_6 (required) 6. Does the child clearly respond to the person's voice?
Materials:Bell, and Rattle
Trials: 2
Question relevant when: ${pre_lrec_8} =1 or ${pre_lrec_10} =0
1 Yes
0 No
pre_lrec_7 (required) 7. Does the child clearly respond to sound of the rattle?
Materials: Paper, and Rattle
Question relevant when: ${pre_lrec_6} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_lrec > gr_start_de_lrec
Group relevant when: ( ${month_calculate_str} > 3.5 and ${month_calculate_str} <=5.5) or ${pre_lrec_6} =0 or ${pre_lrec_7} =0 or ${pre_lrec_8} =0
generated_note_name_752 Start point D and E
pre_lrec_3 (required) 3. Does the child calm when spoken to? 1 Yes
0 No
pre_lrec_4 (required) 4. Does the child clearly react to the sound presented?
Materials: Squeeze toy
Question relevant when: ${pre_lrec_3} =1
1 Yes
0 No
Field Question Answer
pre_lrec_5 (required) 5. Does the child clearly respond to the person's voice?
Question relevant when: ${pre_lrec_4} =1
1 Yes
0 No
generated_note_name_764 [ENUMERATOR] Please contact your supervisor. We couldn't calculate the start point. Please, reschedule the
interview with [fullname_caregiver].
Question relevant when: ${start_group_lrec} = ''
generated_note_name_766 [ENUMERATOR] This child is performing below expectations for their age. If the child is distracted or not feeling well,
please take a break. Please also let your supervisor know that this child is having extreme difficulty.
Question relevant when: ${sum_passing_lrec} > 2 and ${start_group_lrec} != ''
failing_lrec (required) Why is the child failing?
Question relevant when: ${sum_passing_lrec} > 2
Response constrained to: string-length(.) > 3
Survey > Child Development Survey > (receptive comm) Language: Receptive Communication Subtest
generated_note_name_775 Receptive Communication Subtest
Thanks, now Im goint to start the Receptive Communication Subtest.
Question relevant when: ${start_group_lrec} != ''
generated_note_name_776 [ENUM]: Below, will appear some questions blocked, you have previously answered them to determine the starting
point.
Please, just click next.
Question relevant when: ${start_group_lrec} != ''
generated_note_name_778 Start point A, B and C
Question relevant when: ${start_group_lrec} ='ABC'
lrec_1 (required) 1. Does the child fix gaze on the person for at least 2 seconds?
Question relevant when: ${start_group_lrec} ='ABC'
1 Yes
0 No
lrec_2 (required) 2. Does the child tolerate attention and does not show signs of distress?
Question relevant when: ${start_group_lrec} ='ABC'
1 Yes
0 No
generated_note_name_781 Start point D and E
Question relevant when: ${start_group_lrec} ='DE'
lrec_3 (required) 3. Does the child calm when spoken to?
Question relevant when: ${start_group_lrec} ='ABC' or ${start_group_lrec} ='DE'
1 Yes
0 No
lrec_4 (required) 4. Does the child clearly react to the sound presented?
Materials: Squeeze toy
Question relevant when: ${start_group_lrec} ='ABC' or ${start_group_lrec} ='DE'
1 Yes
0 No
lrec_5 (required) 5. Does the child clearly respond to the person's voice? 1 Yes
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Annex E: Study Instrument
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Field Question Answer
Question relevant when: ${start_group_lrec} ='ABC' or ${start_group_lrec} ='DE' 0 No
generated_note_name_785 Start point F, G and H
Question relevant when: ${start_group_lrec} ='FGH'
lrec_6 (required) 6. Does the child clearly respond to the person's voice?
Materials:Bell, and Rattle
Trials: 2
Question relevant when: ${start_group_lrec} ='DE' or ${start_group_lrec} ='FGH' or ( ${lrec_1} + ${lrec_2} +
${lrec_3} + ${lrec_4} + ${lrec_5} ) >=1
1 Yes
0 No
lrec_7 (required) 7. Does the child clearly respond to sound of the rattle?
Materials: Paper, and Rattle
Question relevant when: ${start_group_lrec} ='DE' or ${start_group_lrec} ='FGH' or ( ${lrec_2} + ${lrec_3} +
${lrec_4} + ${lrec_5} + ${lrec_6} ) >=1
1 Yes
0 No
generated_note_name_788 Start point I
Question relevant when: ${start_group_lrec} ='I'
lrec_8 (required) 8. Does the child interact with objects for at least 60 seconds?
Materials: Objects of interest, and Stopwatch
Time:60 seconds
Question relevant when: ${start_group_lrec} ='FGH' or ${start_group_lrec} ='I' or ( ${lrec_3} + ${lrec_4} + ${lrec_5}
+ ${lrec_6} + ${lrec_7} ) >=1
1 Yes
0 No
lrec_9 (required) 9. Does the child turn head both times his or her name is called, but does not respond to unfamiliar name?
Question relevant when: ${start_group_lrec} ='FGH' or ${start_group_lrec} ='I' or ( ${lrec_4} + ${lrec_5} + ${lrec_6}
+ ${lrec_7} + ${lrec_8} ) >=1
1 Yes
0 No
generated_note_name_792 Start point J
Question relevant when: ${start_group_lrec} ='J'
lrec_10 (required) 10. Does the child look up and briefly pauses during play when you call his or her name?
Materials: Object of interest
Question relevant when: ${start_group_lrec} ='FGH' or ${start_group_lrec} ='I' or ${start_group_lrec} ='J' or (
${lrec_5} + ${lrec_6} + ${lrec_7} + ${lrec_8} + ${lrec_9} ) >=1
1 Yes
0 No
lrec_11 (required) 11. Does the child respond differentially to at least two familiar words?
Question relevant when: ${start_group_lrec} ='I' or ${start_group_lrec} ='J' or ( ${lrec_6} + ${lrec_7} + ${lrec_8} +
${lrec_9} + ${lrec_10} ) >=1
1 Yes
0 No
Field Question Answer
lrec_12 (required) 12. Does the child stop reaching for object in response to no-no?
Materials: Object of interest
Question relevant when: ${start_group_lrec} ='I' or ${start_group_lrec} ='J' or ( ${lrec_7} + ${lrec_8} + ${lrec_9} +
${lrec_10} + ${lrec_11} ) >=1
1 Yes
0 No
generated_note_name_796 Start point K and L
Question relevant when: ${start_group_lrec} ='KL'
lrec_13 (required) 13. Does the child maintain attention and enjoys interacting with you in a play routine for at least 60 seconds?
Materials: Stopwatch
Time: 60 seconds
Question relevant when: ${start_group_lrec} ='J' or ${start_group_lrec} ='KL' or ( ${lrec_8} + ${lrec_9} + ${lrec_10}
+ ${lrec_11} + ${lrec_12} ) >=1
1 Yes
0 No
lrec_14 (required) 14. Does the child respond in an appropriate manner to at least one spoken request?
Question relevant when: ${start_group_lrec} ='J' or ${start_group_lrec} ='KL' or ( ${lrec_9} + ${lrec_10} +
${lrec_11} + ${lrec_12} + ${lrec_13} ) >=1
1 Yes
0 No
generated_note_name_799 Start point M
Question relevant when: ${start_group_lrec} ='M'
Survey > Child Development Survey > (receptive comm) Language: Receptive Communication Subtest > gr_lrec_15
Group relevant when: ${start_group_lrec} ='KL' or ${start_group_lrec} ='M' or ( ${lrec_10} + ${lrec_11} + ${lrec_12} + ${lrec_13} + ${lrec_14} ) >=1
note_lrec_15 15. Does the child correctly identify the following objects…?
Materials: Story Book, Plastic cup, Spoon, Small ball, and Doll
1 Yes
0 No
lrec_item_15_1 (required) Book
Question relevant when: ${pre_lrec_item_15_1} != null
1 Yes
0 No
lrec_item_15_2 (required) Spoon
Question relevant when: ${pre_lrec_item_15_2} != null
1 Yes
0 No
lrec_item_15_3 (required) Doll
Question relevant when: ${pre_lrec_item_15_3} != null
1 Yes
0 No
lrec_item_15_4 (required) Cup
Question relevant when: ${pre_lrec_item_15_4} != null
1 Yes
0 No
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
44
Field Question Answer
lrec_item_15_5 (required) Ball
Question relevant when: ${pre_lrec_item_15_5} != null
1 Yes
0 No
lrec_16 (required) 16. Does the child correctly identify the object you name?
Question relevant when: ${start_group_lrec} ='KL' or ${start_group_lrec} ='M' or ( ${lrec_11} + ${lrec_12} +
${lrec_13} + ${lrec_14} + ${lrec_15} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (receptive comm) Language: Receptive Communication Subtest > gr_lrec_17
Group relevant when: ${start_group_lrec} ='KL' or ${start_group_lrec} ='M' or ( ${lrec_12} + ${lrec_13} + ${lrec_14} + ${lrec_15} + ${lrec_16} ) >=1
note_lrec_17 17. Does the child correctly identify the [item] pictures…?
Materials: Picture Book (pp.1-5)
1 Yes
0 No
lrec_item_17_1 (required) Biscuit
Question relevant when: ${pre_lrec_item_17_1} != null
1 Yes
0 No
lrec_item_17_2 (required) Shoe(s)
Question relevant when: ${pre_lrec_item_17_2} != null
1 Yes
0 No
lrec_item_17_3 (required) Car
Question relevant when: ${pre_lrec_item_17_3} != null
1 Yes
0 No
lrec_item_17_4 (required) Balloon(s)
Question relevant when: ${pre_lrec_item_17_4} != null
1 Yes
0 No
lrec_item_17_5 (required) Bird
Question relevant when: ${pre_lrec_item_17_5} != null
1 Yes
0 No
lrec_item_17_6 (required) Bed
Question relevant when: ${pre_lrec_item_17_6} != null
1 Yes
0 No
lrec_item_17_7 (required) Kitten
Question relevant when: ${pre_lrec_item_17_7} != null
1 Yes
0 No
lrec_item_17_8 (required) Spoon
Question relevant when: ${pre_lrec_item_17_8} != null
1 Yes
0 No
lrec_item_17_9 (required) Ball
Question relevant when: ${pre_lrec_item_17_9} != null
1 Yes
0 No
lrec_item_17_10 (required) Book
Question relevant when: ${pre_lrec_item_17_10} != null
1 Yes
0 No
lrec_item_17_11 (required) Cup
Question relevant when: ${pre_lrec_item_17_11} != null
1 Yes
0 No
lrec_item_17_12 (required) Banana
Question relevant when: ${pre_lrec_item_17_12} != null
1 Yes
0 No
lrec_18 (required) 18. Does the child pause in response to inhibitory words during a play routine? 1 Yes
Field Question Answer
Materials: 2 ducks, and 6 blocks
Question relevant when: ${start_group_lrec} ='M' or ( ${lrec_13} + ${lrec_14} + ${lrec_15} + ${lrec_16} +
${lrec_17} ) >=1
0 No
generated_note_name_827 Start point N
Question relevant when: ${start_group_lrec} ='N'
Survey > Child Development Survey > (receptive comm) Language: Receptive Communication Subtest > gr_lrec_19
Group relevant when: ${start_group_lrec} ='M' or ${start_group_lrec} ='N' or ( ${lrec_14} + ${lrec_15} + ${lrec_16} + ${lrec_17} + ${lrec_18} ) >=1
note_lrec_19 19. Does the child correctly identify the objects…?
Materials: Story Book, Plastic cup, Spoon, Small ball, and Doll
1 Yes
0 No
lrec_item_19_1 (required) Book
Question relevant when: ${pre_lrec_item_19_1} != null
1 Yes
0 No
lrec_item_19_2 (required) Spoon
Question relevant when: ${pre_lrec_item_19_2} != null
1 Yes
0 No
lrec_item_19_3 (required) Doll
Question relevant when: ${pre_lrec_item_19_3} != null
1 Yes
0 No
lrec_item_19_4 (required) Cup
Question relevant when: ${pre_lrec_item_19_4} != null
1 Yes
0 No
lrec_item_19_5 (required) Ball 1 Yes
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Field Question Answer
Question relevant when: ${pre_lrec_item_19_5} != null 0 No
lrec_20 (required) 20. Does the child correctly respond to at least two directions with the doll or bear?
Materials: Doll or bear, Spoon, Comb, and Facial tissue
Question relevant when: ${start_group_lrec} ='N' or ( ${lrec_15} + ${lrec_16} + ${lrec_17} + ${lrec_18} + ${lrec_19}
) >=1
1 Yes
0 No
Survey > Child Development Survey > (receptive comm) Language: Receptive Communication Subtest > gr_lrec_21
Group relevant when: ${start_group_lrec} ='N' or ( ${lrec_16} + ${lrec_17} + ${lrec_18} + ${lrec_19} + ${lrec_20} ) >=1
note_lrec_21 21. Does the child correctly identify the [item] pictures…?
Materials: Picture Book (pp.1-5)
1 Yes
0 No
lrec_item_21_1 (required) Biscuit
Question relevant when: ${pre_lrec_item_21_1} != null
1 Yes
0 No
lrec_item_21_2 (required) Shoe(s)
Question relevant when: ${pre_lrec_item_21_2} != null
1 Yes
0 No
lrec_item_21_3 (required) Car
Question relevant when: ${pre_lrec_item_21_3} != null
1 Yes
0 No
lrec_item_21_4 (required) Balloon(s)
Question relevant when: ${pre_lrec_item_21_4} != null
1 Yes
0 No
lrec_item_21_5 (required) Bird
Question relevant when: ${pre_lrec_item_21_5} != null
1 Yes
0 No
lrec_item_21_6 (required) Bed
Question relevant when: ${pre_lrec_item_21_6} != null
1 Yes
0 No
lrec_item_21_7 (required) Kitten
Question relevant when: ${pre_lrec_item_21_7} != null
1 Yes
0 No
lrec_item_21_8 (required) Spoon
Question relevant when: ${pre_lrec_item_21_8} != null
1 Yes
0 No
lrec_item_21_9 (required) Ball
Question relevant when: ${pre_lrec_item_21_9} != null
1 Yes
0 No
lrec_item_21_10 (required) Book
Question relevant when: ${pre_lrec_item_21_10} != null
1 Yes
0 No
lrec_item_21_11 (required) Cup
Question relevant when: ${pre_lrec_item_21_11} != null
1 Yes
0 No
lrec_item_21_12 (required) Banana
Question relevant when: ${pre_lrec_item_21_12} != null
1 Yes
0 No
generated_note_name_854 Start point O
Question relevant when: ${start_group_lrec} ='O'
lrec_22 (required) 22. Does the child correctly identify at least three clothing items?
Question relevant when: ${start_group_lrec} ='N' or ${start_group_lrec} ='O' or ( ${lrec_17} + ${lrec_18} +
${lrec_19} + ${lrec_20} + ${lrec_21} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (receptive comm) Language: Receptive Communication Subtest > gr_lrec_23
Group relevant when: ${start_group_lrec} ='N' or ${start_group_lrec} ='O' or ( ${lrec_18} + ${lrec_19} + ${lrec_20} + ${lrec_21} + ${lrec_22} ) >=1
note_lrec_23 23. Does the child correctly identify the pictures…?
Materials: Picture Book (pp. 6-9)
1 Yes
0 No
Field Question Answer
lrec_item_23_1 (required) Waving
Question relevant when: ${pre_lrec_item_23_1} != null
1 Yes
0 No
lrec_item_23_2 (required) Sleeping
Question relevant when: ${pre_lrec_item_23_2} != null
1 Yes
0 No
lrec_item_23_3 (required) Drinking
Question relevant when: ${pre_lrec_item_23_3} != null
1 Yes
0 No
lrec_item_23_4 (required) Washing
Question relevant when: ${pre_lrec_item_23_4} != null
1 Yes
0 No
lrec_item_23_5 (required) Riding
Question relevant when: ${pre_lrec_item_23_5} != null
1 Yes
0 No
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
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Field Question Answer
lrec_item_23_6 (required) Eating
Question relevant when: ${pre_lrec_item_23_6} != null
1 Yes
0 No
lrec_item_23_7 (required) Reading
Question relevant when: ${pre_lrec_item_23_7} != null
1 Yes
0 No
lrec_item_23_8 (required) Running
Question relevant when: ${pre_lrec_item_23_8} != null
1 Yes
0 No
lrec_24 (required) 24. Does the child correctly point to at least five body parts?
Materials: Doll
Question relevant when: ${start_group_lrec} ='O' or ( ${lrec_19} + ${lrec_20} + ${lrec_21} + ${lrec_22} +
${lrec_23} ) >=1
1 Yes
0 No
generated_note_name_869 Start point P
Question relevant when: ${start_group_lrec} ='P'
lrec_25 (required) 25. Does the child correctly follow at least one two-part direction in its entirety?
Materials: 3 objects of interest
Question relevant when: ${start_group_lrec} ='O' or ${start_group_lrec} ='P' or ( ${lrec_20} + ${lrec_21} +
${lrec_22} + ${lrec_23} + ${lrec_24} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (receptive comm) Language: Receptive Communication Subtest > gr_lrec_26
Group relevant when: ${start_group_lrec} ='O' or ${start_group_lrec} ='P' or ( ${lrec_21} + ${lrec_22} + ${lrec_23} + ${lrec_24} + ${lrec_25} ) >=1
note_lrec_26 26. Does the child correctly identify the pictures …?
Materials: Picture Book (pp. 6-9)
1 Yes
0 No
lrec_item_26_1 (required) Waving
Question relevant when: ${pre_lrec_item_26_1} != null
1 Yes
0 No
lrec_item_26_2 (required) Sleeping
Question relevant when: ${pre_lrec_item_26_2} != null
1 Yes
0 No
lrec_item_26_3 (required) Drinking
Question relevant when: ${pre_lrec_item_26_3} != null
1 Yes
0 No
lrec_item_26_4 (required) Washing
Question relevant when: ${pre_lrec_item_26_4} != null
1 Yes
0 No
lrec_item_26_5 (required) Riding
Question relevant when: ${pre_lrec_item_26_5} != null
1 Yes
0 No
lrec_item_26_6 (required) Eating
Question relevant when: ${pre_lrec_item_26_6} != null
1 Yes
0 No
lrec_item_26_7 (required) Reading
Question relevant when: ${pre_lrec_item_26_7} != null
1 Yes
0 No
lrec_item_26_8 (required) Running
Question relevant when: ${pre_lrec_item_26_8} != null
1 Yes
0 No
Survey > Child Development Survey > (receptive comm) Language: Receptive Communication Subtest > gr_lrec_27
Group relevant when: ${start_group_lrec} ='P' or ( ${lrec_22} + ${lrec_23} + ${lrec_24} + ${lrec_25} + ${lrec_26} ) >=1
note_lrec_27 27. Does the child correctly identify the pictures …?
Materials: Stimulus Book (p. 79)
1 Yes
0 No
lrec_item_27_1 (required) Tricycie
Question relevant when: ${pre_lrec_item_27_1} != null
1 Yes
0 No
lrec_item_27_2 (required) Scissors
Question relevant when: ${pre_lrec_item_27_2} != null
1 Yes
0 No
lrec_item_27_3 (required) Shoe
Question relevant when: ${pre_lrec_item_27_3} != null
1 Yes
0 No
lrec_item_27_4 (required) Pot
Question relevant when: ${pre_lrec_item_27_4} != null
1 Yes
0 No
lrec_item_27_5 (required) Crayon
Question relevant when: ${pre_lrec_item_27_5} != null
1 Yes
0 No
Field Question Answer
lrec_item_27_6 (required) Glass
Question relevant when: ${pre_lrec_item_27_6} != null
1 Yes
0 No
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Annex E: Study Instrument
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Field Question Answer
generated_note_name_893 Start point Q
Question relevant when: ${start_group_lrec} ='Q'
lrec_28 (required) 28. Does the child correctly identify at least three objects you name?
Materials: Stimulus Book (p.81)
Question relevant when: ${start_group_lrec} ='P' or ${start_group_lrec} ='Q' or ( ${lrec_23} + ${lrec_24} +
${lrec_25} + ${lrec_26} + ${lrec_27} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (receptive comm) Language: Receptive Communication Subtest > gr_lrec_29
Group relevant when: ${start_group_lrec} ='P' or ${start_group_lrec} ='Q' or ( ${lrec_24} + ${lrec_25} + ${lrec_26} + ${lrec_27} + ${lrec_28} ) >=1
note_lrec_29 29. Does the child correctly identify the pictures…?
Materials: Picture Book (pp.6- 9)
1 Yes
0 No
lrec_item_29_1 (required) Waving
Question relevant when: ${pre_lrec_item_29_1} != null
1 Yes
0 No
lrec_item_29_2 (required) Sleeping
Question relevant when: ${pre_lrec_item_29_2} != null
1 Yes
0 No
lrec_item_29_3 (required) Drinking
Question relevant when: ${pre_lrec_item_29_3} != null
1 Yes
0 No
lrec_item_29_4 (required) Washing
Question relevant when: ${pre_lrec_item_29_4} != null
1 Yes
0 No
lrec_item_29_5 (required) Riding
Question relevant when: ${pre_lrec_item_29_5} != null
1 Yes
0 No
lrec_item_29_6 (required) Eating
Question relevant when: ${pre_lrec_item_29_6} != null
1 Yes
0 No
lrec_item_29_7 (required) Reading
Question relevant when: ${pre_lrec_item_29_7} != null
1 Yes
0 No
lrec_item_29_8 (required) Running
Question relevant when: ${pre_lrec_item_29_8} != null
1 Yes
0 No
Survey > Child Development Survey > (receptive comm) Language: Receptive Communication Subtest > gr_lrec_30
Group relevant when: ${start_group_lrec} ='Q' or ( ${lrec_25} + ${lrec_26} + ${lrec_27} + ${lrec_28} + ${lrec_29} ) >=1
note_lrec_30 30. Does the child correctly respond to directions, understanding the pronouns …?
Materials: Bear, 3 plastic cups, and 3 spoons
1 Yes
0 No
lrec_item_30_1 (required) Him
Question relevant when: ${pre_lrec_item_30_1} != null
1 Yes
0 No
lrec_item_30_2 (required) Me
Question relevant when: ${pre_lrec_item_30_2} != null
1 Yes
0 No
lrec_item_30_3 (required) My
Question relevant when: ${pre_lrec_item_30_3} != null
1 Yes
0 No
lrec_item_30_4 (required) You
Question relevant when: ${pre_lrec_item_30_4} != null
1 Yes
0 No
lrec_item_30_5 (required) Your
Question relevant when: ${pre_lrec_item_30_5} != null
1 Yes
0 No
Survey > Child Development Survey > (receptive comm) Language: Receptive Communication Subtest > gr_lrec_31
Group relevant when: ${start_group_lrec} ='Q' or ( ${lrec_26} + ${lrec_27} + ${lrec_28} + ${lrec_29} + ${lrec_30} ) >=1
note_lrec_31 31. Does the child correctly identify both –big and little objects– in the pairs of pictures…?
Materials: Stimulus Book (p. 83)
1 Yes
0 No
lrec_item_31_1 (required) Shoes 1 Yes
0 No
lrec_item_31_2 (required) Trucks 1 Yes
0 No
lrec_item_31_3 (required) Dogs 1 Yes
0 No
Survey > Child Development Survey > (receptive comm) Language: Receptive Communication Subtest > gr_lrec_32
Group relevant when: ${start_group_lrec} ='Q' or ( ${lrec_27} + ${lrec_28} + ${lrec_29} + ${lrec_30} + ${lrec_31} ) >=1
note_lrec_32 32. Does the child correctly follows directions for the tasks?
Materials: Cup with handle, Shoelace, and Block with hole
1 Yes
0 No
lrec_item_32_1 (required) On 1 Yes
0 No
TOPS Uganda Graduation RCT Associate Award
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Field Question Answer
lrec_item_32_2 (required) Around 1 Yes
0 No
Field Question Answer
lrec_item_32_3 (required) Between 1 Yes
0 No
lrec_item_32_4 (required) Through 1 Yes
0 No
lrec_item_32_5 (required) Against 1 Yes
0 No
lrec_item_32_6 (required) In/After 1 Yes
0 No
Survey > Child Development Survey > (receptive comm) Language: Receptive Communication Subtest > gr_lrec_33
Group relevant when: ( ${lrec_28} + ${lrec_29} + ${lrec_30} + ${lrec_31} + ${lrec_32} ) >=1
note_lrec_33 33. Does the child correctly identify the object in the pictures?
Materials: Stimulus Book (pp.85-89)
1 Yes
0 No
lrec_item_33_1 (required) Boy's car 1 Yes
0 No
lrec_item_33_2 (required) Baby's bear 1 Yes
0 No
lrec_item_33_3 (required) Cat's ball 1 Yes
0 No
lrec_34 (required) 34. Does the child correctly identify both pictures?
Materials: Stimulus Book (pp. 91-93)
Question relevant when: ( ${lrec_29} + ${lrec_30} + ${lrec_31} + ${lrec_32} + ${lrec_33} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (receptive comm) Language: Receptive Communication Subtest > gr_lrec_35
Group relevant when: ( ${lrec_30} + ${lrec_31} + ${lrec_32} + ${lrec_33} + ${lrec_34} ) >=1
note_lrec_35 35. Does the child correctly identify the colors named?
Materials: Stimulus Book (p. 95)
1 Yes
0 No
lrec_item_35_1 (required) Red 1 Yes
0 No
lrec_item_35_2 (required) Yellow 1 Yes
0 No
lrec_item_35_3 (required) Green 1 Yes
0 No
lrec_item_35_4 (required) Brown 1 Yes
0 No
lrec_item_35_5 (required) Purple 1 Yes
0 No
lrec_item_35_6 (required) White 1 Yes
0 No
lrec_36 (required) 36. Does the child identify correct picture?
Materials: Stimulus Book (p. 97)
Question relevant when: ( ${lrec_31} + ${lrec_32} + ${lrec_33} + ${lrec_34} + ${lrec_35} ) >=1
1 Yes
0 No
lrec_39 (required) 39. Does the child correctly identify all four pictures?
Materials: Stimulus Book (p. 107)
Question relevant when: ( ${lrec_32} + ${lrec_33} + ${lrec_34} + ${lrec_35} + ${lrec_36} ) >=1
1 Yes
0 No
lrec_40 (required) 40. Does the child correctly identify both pictures?
Materials: Stimulus Book (pp. 109-111)
Question relevant when: ( ${lrec_33} + ${lrec_34} + ${lrec_35} + ${lrec_36} + ${lrec_39} ) >=1
1 Yes
0 No
lrec_41 (required) 41. Does the child correctly identify both pictures?
Materials: Stimulus Book (pp. 113-115)
Question relevant when: ( ${lrec_34} + ${lrec_35} + ${lrec_36} + ${lrec_39} + ${lrec_40} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (receptive comm) Language: Receptive Communication Subtest > gr_lrec_42
Group relevant when: ( ${lrec_35} + ${lrec_36} + ${lrec_39} + ${lrec_40} + ${lrec_41} ) >=1
note_lrec_42 42. Does the child correctly follow directions for the tasks? 1 Yes
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
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Field Question Answer
Materials: Cup with handle, Shoelace, and Block with hole 0 No
lrec_item_42_1 (required) On 1 Yes
0 No
lrec_item_42_2 (required) Around 1 Yes
0 No
lrec_item_42_3 (required) Between 1 Yes
0 No
lrec_item_42_4 (required) Through 1 Yes
0 No
Field Question Answer
lrec_item_42_5 (required) Against 1 Yes
0 No
lrec_item_42_6 (required) In/After 1 Yes
0 No
Survey > Child Development Survey > (receptive comm) Language: Receptive Communication Subtest > gr_lrec_43
Group relevant when: ( ${lrec_36} + ${lrec_39} + ${lrec_40} + ${lrec_41} + ${lrec_42} ) >=1
note_lrec_43 43. Does the child correctly identifies the pictures?
Materials: Stimulus Book (pp. 117-121)
1 Yes
0 No
lrec_item_43_1 (required) Baby 1 Yes
0 No
lrec_item_43_2 (required) Chicken 1 Yes
0 No
lrec_item_43_3 (required) Child 1 Yes
0 No
lrec_44 (required) 44. Does the child correctly identifies both pictures?
Materials: Stimulus Book (pp. 123-125)
Question relevant when: ( ${lrec_39} + ${lrec_40} + ${lrec_41} + ${lrec_42} + ${lrec_43} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (receptive comm) Language: Receptive Communication Subtest > gr_lrec_45
Group relevant when: ( ${lrec_40} + ${lrec_41} + ${lrec_42} + ${lrec_43} + ${lrec_44} ) >=1
note_lrec_45 45. Does the child identify the correct object in the pairs of pictures?
Materials: Stimulus Book (pp.127-131)
1 Yes
0 No
lrec_item_45_1 (required) Heavy 1 Yes
0 No
lrec_item_45_2 (required) Light 1 Yes
0 No
lrec_item_45_3 (required) Light 1 Yes
0 No
lrec_46 (required) 46. Does the child correctly identifies both pictures?
Materials: Stimulus Book (pp. 133-135)
Question relevant when: ( ${lrec_41} + ${lrec_42} + ${lrec_43} + ${lrec_44} + ${lrec_45} ) >=1
1 Yes
0 No
lrec_47 (required) 47. Does the child correctly identifies both pictures?
Materials: Stimulus Book (pp. 137-139)
Question relevant when: ( ${lrec_42} + ${lrec_43} + ${lrec_44} + ${lrec_45} + ${lrec_46} ) >=1
1 Yes
0 No
lrec_48 (required) 48. Does the child correctly identifies at least one animal for all four descriptions?
Materials: Stimulus Book (p.141)
Question relevant when: ( ${lrec_43} + ${lrec_44} + ${lrec_45} + ${lrec_46} + ${lrec_47} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (receptive comm) Language: Receptive Communication Subtest > gr_lrec_49
Group relevant when: ( ${lrec_44} + ${lrec_45} + ${lrec_46} + ${lrec_47} + ${lrec_48} ) >=1
note_lrec_49 49. Does the child correctly identifies all items in the category, without including any extraneous items?
Categories:
Materials: Stimulus Book (pp.143-145)
1 Yes
0 No
lrec_item_49_1 (required) Feed 1 Yes
0 No
lrec_item_49_2 (required) Wear 1 Yes
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Annex E: Study Instrument
50
Field Question Answer
0 No
lrec_item_49_3 (required) Furniture 1 Yes
0 No
lrec_item_49_4 (required) Fruit 1 Yes
0 No
lrec_item_49_5 (required) Edible 1 Yes
0 No
lrec_item_49_6 (required) Toys 1 Yes
0 No
lrec_comments (required) (comments) Comments about Language: Receptive Communication Subtest:
Enter -999 if you dont have any comments
Question relevant when: ${start_group_lrec} != ''
Response constrained to: string-length(.) > 3
Survey > Child Development Survey > determine_start_lexp
Group relevant when: ${start_group_lrec} != ''
generated_note_name_1005 We have finished with the Receptive Communication Subtest.
Field Question Answer
Now, I'm going to ask you a couple of questions to determine where we should start the the Expressive
Communication Subtest.
Survey > Child Development Survey > determine_start_lexp > gr_start_q_lexp
Group relevant when: ${month_calculate_str} >=39
generated_note_name_1008 Start point Q
pre_lexp_30 (required) 30. Does the child use at least one pronoun?
Materials: Objects of interest
1 Yes
0 No
Survey > Child Development Survey > determine_start_lexp > gr_start_q_lexp > pre_gr_lexp_31
Group relevant when: ${pre_lexp_30} =1
note_pre_lexp_31 31. Does the child correctly name the action in at least one picture?
Materials: Picture Book (pp. 16-21)
1 Yes
0 No
pre_lexp_item_31_1 (required) Eating 1 Yes
0 No
pre_lexp_item_31_2 (required) Hugging 1 Yes
0 No
pre_lexp_item_31_3 (required) Yawning 1 Yes
0 No
pre_lexp_item_31_4 (required) Playing 1 Yes
0 No
pre_lexp_item_31_5 (required) Running 1 Yes
0 No
pre_lexp_item_31_6 (required) Sweeping 1 Yes
0 No
pre_lexp_item_31_7 (required) Sleeping 1 Yes
0 No
pre_lexp_item_31_8 (required) Kicking 1 Yes
0 No
pre_lexp_item_31_9 (required) Washing clothes 1 Yes
0 No
pre_lexp_item_31_10 (required) Bathing 1 Yes
0 No
pre_lexp_item_31_11 (required) Climbing 1 Yes
0 No
pre_lexp_item_31_12 (required) Washing dishes 1 Yes
0 No
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Annex E: Study Instrument
51
Field Question Answer
pre_lexp_32 (required) 32. Does the child pose at least one two-word or multiple-word question?
Question relevant when: ${pre_lexp_31} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_lexp > gr_start_p_lexp
Group relevant when: ( ${month_calculate_str} >=33 and ${month_calculate_str} <39) or ${pre_lexp_30} =0 or ${pre_lexp_31} =0 or ${pre_lexp_32} =0
generated_note_name_1032 Start point P
pre_lexp_27 (required) 27. Does the child correctly name at least three objects?
Materials: Story Book, Small ball, Doll, Spoon, and Plastic cup
1 Yes
0 No
Survey > Child Development Survey > determine_start_lexp > gr_start_p_lexp > pre_gr_lexp_28
Group relevant when: ${pre_lexp_27} =1
note_pre_lexp_28 28. Does the child correctly names the pictures?
Materials: Picture Book (pp.1O-15)
1 Yes
0 No
pre_lexp_item_28_1 (required) Biscuit 1 Yes
0 No
pre_lexp_item_28_2 (required) Bottle 1 Yes
0 No
pre_lexp_item_28_3 (required) Shoe(s) 1 Yes
0 No
pre_lexp_item_28_4 (required) Truck 1 Yes
0 No
pre_lexp_item_28_5 (required) Bird 1 Yes
0 No
pre_lexp_item_28_6 (required) Balloon(s) 1 Yes
0 No
pre_lexp_item_28_7 (required) Bed 1 Yes
Field Question Answer
0 No
pre_lexp_item_28_8 (required) Kitten 1 Yes
0 No
pre_lexp_item_28_9 (required) Ball 1 Yes
0 No
pre_lexp_item_28_10 (required) Spoon 1 Yes
0 No
pre_lexp_item_28_11 (required) Banana 1 Yes
0 No
pre_lexp_item_28_12 (required) Book 1 Yes
0 No
pre_lexp_29 (required) 29. Does the child use at least two multiple-word utterances?
Question relevant when: ${pre_lexp_28} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_lexp > gr_start_o_lexp
Group relevant when: ( ${month_calculate_str} >28.5 and ${month_calculate_str} <33) or ${pre_lexp_27} =0 or ${pre_lexp_28} =0 or ${pre_lexp_29} =0
generated_note_name_1056 Start point O
pre_lexp_23 (required) 23. Does the child use at least eight different words appropriately?
Materials: Objects of interest
1 Yes
0 No
pre_lexp_24 (required) 24. Does the child use yes or no appropriately in at least two response?
Materials: Objects of interest
Question relevant when: ${pre_lexp_23} =1
1 Yes
0 No
pre_lexp_25 (required) 25. Does the child imitate a two-word or multiple-word utterance?
Question relevant when: ${pre_lexp_24} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_lexp > gr_start_mn_lexp
Group relevant when: ( ${month_calculate_str} >22.5 and ${month_calculate_str} <=28.5) or ${pre_lexp_23} =0 or ${pre_lexp_24} =0 or ${pre_lexp_25} =0
generated_note_name_1065 Start point M and N
pre_lexp_20 (required) 20. Does the child correctly name at least one object?
Materials: Story Book, Small ball, Doll, Spoon, and Plastic cup
1 Yes
0 No
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
52
Field Question Answer
pre_lexp_21 (required) 21. Does the child use at least one word and gesture combination?
Question relevant when: ${pre_lexp_20} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_lexp > gr_start_mn_lexp > pre_gr_lexp_22
Group relevant when: ${pre_lexp_21} =1
note_pre_lexp_22 22. Does the child correctly names the pictures?
Materials: Picture Book (pp. 10- 15)
1 Yes
0 No
pre_lexp_item_22_1 (required) Biscuit 1 Yes
0 No
pre_lexp_item_22_2 (required) Bottle 1 Yes
0 No
pre_lexp_item_22_3 (required) Shoe(s) 1 Yes
0 No
pre_lexp_item_22_4 (required) Car 1 Yes
0 No
pre_lexp_item_22_5 (required) Bird 1 Yes
0 No
pre_lexp_item_22_6 (required) Balloon(s) 1 Yes
0 No
pre_lexp_item_22_7 (required) Bed 1 Yes
0 No
pre_lexp_item_22_8 (required) Kitten 1 Yes
0 No
pre_lexp_item_22_9 (required) Ball 1 Yes
0 No
pre_lexp_item_22_10 (required) Spoon 1 Yes
0 No
pre_lexp_item_22_11 (required) Banana 1 Yes
0 No
pre_lexp_item_22_12 (required) Book 1 Yes
0 No
Survey > Child Development Survey > determine_start_lexp > gr_start_l_lexp
Group relevant when: ( ${month_calculate_str} >19.5 and ${month_calculate_str} <=22.5) or ${pre_lexp_20} =0 or ${pre_lexp_21} =0 or ${pre_lexp_22} =0
Field Question Answer
generated_note_name_1089 Start point L
pre_lexp_17 (required) 17. Does the child initiate at least one interaction for play?
Materials: Objects of interest
1 Yes
0 No
pre_lexp_18 (required) 18. Does the child use at least two different words appropriately?
Materials: Objects of interest
Question relevant when: ${pre_lexp_17} =1
1 Yes
0 No
pre_lexp_19 (required) 19. Does the child use at least one word to make wants known?
Question relevant when: ${pre_lexp_18} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_lexp > gr_start_k_lexp
Group relevant when: ( ${month_calculate_str} >16.5 and ${month_calculate_str} <=19.5) or ${pre_lexp_17} =0 or ${pre_lexp_18} =0 or ${pre_lexp_19} =0
generated_note_name_1098 Start point K
pre_lexp_14 (required) 14. Does the child produce at least lone-word approximation? 1 Yes
0 No
pre_lexp_15 (required) 15. Does the child point to or show you at least one object?
Materials: Objects of interest
Question relevant when: ${pre_lexp_14} =1
1 Yes
0 No
pre_lexp_16 (required) 16. Does the child imitate at least one word, even if imitation consists of vowels only?
Question relevant when: ${pre_lexp_15} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_lexp > gr_start_j_lexp
Group relevant when: ( ${month_calculate_str} >13.5 and ${month_calculate_str} <=16.5) or ${pre_lexp_14} =0 or ${pre_lexp_15} =0 or ${pre_lexp_16} =0
generated_note_name_1107 Start point J
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
53
Field Question Answer
pre_lexp_10 (required) 10. Does the child imitate at least one repetitive consonant-vowel combination? 1 Yes
0 No
pre_lexp_11 (required) 11. Does the child actively participate in at least one play routine?
Materials: Objects of interest
Question relevant when: ${pre_lexp_10} =1
1 Yes
0 No
pre_lexp_12 (required) 12. Does the child produce at least one vocalization that contains inflections and is expressive?
Question relevant when: ${pre_lexp_11} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_lexp > gr_start_i_lexp
Group relevant when: ( ${month_calculate_str} >=11 and ${month_calculate_str} <=13.5) or ${pre_lexp_10} =0 or ${pre_lexp_11} =0 or ${pre_lexp_12} =0
generated_note_name_1116 Start point I
pre_lexp_7 (required) 7. Does the child try to get attention from you or others? 1 Yes
0 No
pre_lexp_8 (required) 8. Does the child produce at least two different, distinct consonant sounds?
Materials: Objects of interest
Question relevant when: ${pre_lexp_7} =1
1 Yes
0 No
pre_lexp_9 (required) 9. Does the child use at least one gesture to make wants known?
Question relevant when: ${pre_lexp_8} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_lexp > gr_start_efgh_lexp
Group relevant when: ( ${month_calculate_str} >4.5 and ${month_calculate_str} <11) or ${pre_lexp_7} =0 or ${pre_lexp_8} =0 or ${pre_lexp_9} =0
generated_note_name_1125 Start point E, F, G and H
pre_lexp_3 (required) 3. Does the child produce vocalizations that express at least one mood? 1 Yes
0 No
pre_lexp_4 (required) 4. Does the child produce nasal vocalizations?
Question relevant when: ${pre_lexp_3} =1
1 Yes
0 No
pre_lexp_5 (required) 5. Does the child vocalize or laughs in response to speaker's attention?
Question relevant when: ${pre_lexp_4} =1
1 Yes
0 No
generated_note_name_1137 [ENUMERATOR] Please contact your supervisor. We couldn't calculate the start point. Please, reschedule the
interview with [fullname_caregiver].
Question relevant when: ${start_group_lexp} =''
generated_note_name_1139 [ENUMERATOR] This child is performing below expectations for their age. If the child is distracted or not feeling well,
please take a break. Please also let your supervisor know that this child is having extreme difficulty.
Question relevant when: ${sum_passing_lexp} > 2 and ${start_group_lexp} !=''
failing_lexp (required) Why is the child failing?
Question relevant when: ${sum_passing_lexp} > 2
Response constrained to: string-length(.) > 3
Survey > Child Development Survey > (expressive comm) Language: Expressive Communication Subtest
generated_note_name_1148 Expressive Communication Subtest
Thanks, now Im goint to start the Expressive Communication Subtest.
Question relevant when: ${start_group_lexp} !=''
Field Question Answer
generated_note_name_1149 [ENUM]: Below, will appear some questions blocked, you have previously answered them to determine the starting
point.
Please, just click next.
Question relevant when: ${start_group_lexp} !=''
generated_note_name_1151 Start point A, B, C and D
Question relevant when: ${start_group_lexp} ='ABCD'
lexp_1 (required) 1. Does the child produce soft, throaty, gurgling sounds?
Question relevant when: ${start_group_lexp} ='ABCD'
1 Yes
0 No
lexp_2 (required) 2. Does the child smile in response to speaker's attention?
Question relevant when: ${start_group_lexp} ='ABCD'
1 Yes
0 No
generated_note_name_1154 Start point E, F, G and H
Question relevant when: ${start_group_lexp} ='EFGH'
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
54
Field Question Answer
lexp_3 (required) 3. Does the child produce vocalizations that express at least one mood?
Question relevant when: ${start_group_lexp} ='ABCD' or ${start_group_lexp} ='EFGH'
1 Yes
0 No
lexp_4 (required) 4. Does the child produce nasal vocalizations?
Question relevant when: ${start_group_lexp} ='ABCD' or ${start_group_lexp} ='EFGH'
1 Yes
0 No
lexp_5 (required) 5. Does the child vocalize or laughs in response to speaker's attention?
Question relevant when: ${start_group_lexp} ='ABCD' or ${start_group_lexp} ='EFGH'
1 Yes
0 No
lexp_6 (required) 6. Does the child vocalize at least two different, distinct vowel sounds?
Question relevant when: ${start_group_lexp} ='EFGH' or ( ${lexp_1} + ${lexp_2} + ${lexp_3} + ${lexp_4} +
${lexp_5} ) >=1
1 Yes
0 No
generated_note_name_1159 Start point I
Question relevant when: ${start_group_lexp} ='I'
lexp_7 (required) 7. Does the child try to get attention from you or others?
Question relevant when: ${start_group_lexp} ='EFGH' or ${start_group_lexp} ='I' or ( ${lexp_2} + ${lexp_3} +
${lexp_4} + ${lexp_5} + ${lexp_6} ) >=1
1 Yes
0 No
lexp_8 (required) 8. Does the child produce at least two different, distinct consonant sounds?
Materials: Objects of interest
Question relevant when: ${start_group_lexp} ='I' or ( ${lexp_3} + ${lexp_4} + ${lexp_5} + ${lexp_6} + ${lexp_7} )
>=1
1 Yes
0 No
lexp_9 (required) 9. Does the child use at least one gesture to make wants known?
Question relevant when: ${start_group_lexp} ='I' or ( ${lexp_4} + ${lexp_5} + ${lexp_6} + ${lexp_7} + ${lexp_8} )
>=1
1 Yes
0 No
generated_note_name_1164 Start point J
Question relevant when: ${start_group_lexp} ='J'
lexp_10 (required) 10. Does the child imitate at least one repetitive consonant-vowel combination?
Question relevant when: ${start_group_lexp} ='I' or ${start_group_lexp} ='J' or ( ${lexp_5} + ${lexp_6} + ${lexp_7}
+ ${lexp_8} + ${lexp_9} ) >=1
1 Yes
0 No
lexp_11 (required) 11. Does the child actively participate in at least one play routine?
Materials: Objects of interest
Question relevant when: ${start_group_lexp} ='I' or ${start_group_lexp} ='J' or ( ${lexp_6} + ${lexp_7} + ${lexp_8}
+ ${lexp_9} + ${lexp_10} ) >=1
1 Yes
0 No
lexp_12 (required) 12. Does the child produce at least one vocalization that contains inflections and is expressive?
Question relevant when: ${start_group_lexp} ='J' or ( ${lexp_7} + ${lexp_8} + ${lexp_9} + ${lexp_10} + ${lexp_11} )
>=1
1 Yes
0 No
lexp_13 (required) 13. Does the child imitate at least four different repetitive consonant-vowel combinations?
Question relevant when: ${start_group_lexp} ='J' or ( ${lexp_8} + ${lexp_9} + ${lexp_10} + ${lexp_11} + ${lexp_12}
) >=1
1 Yes
0 No
generated_note_name_1169 Start point K
Question relevant when: ${start_group_lexp} ='K'
lexp_14 (required) 14. Does the child produce at least lone-word approximation?
Question relevant when: ${start_group_lexp} ='J' or ${start_group_lexp} ='K' or ( ${lexp_9} + ${lexp_10} +
${lexp_11} + ${lexp_12} + ${lexp_13} ) >=1
1 Yes
0 No
lexp_15 (required) 15. Does the child point to or show you at least one object?
Materials: Objects of interest
Question relevant when: ${start_group_lexp} ='K' or ( ${lexp_10} + ${lexp_11} + ${lexp_12} + ${lexp_13} +
${lexp_14} ) >=1
1 Yes
0 No
lexp_16 (required) 16. Does the child imitate at least one word, even if imitation consists of vowels only?
Question relevant when: ${start_group_lexp} ='K' or ( ${lexp_11} + ${lexp_12} + ${lexp_13} + ${lexp_14} +
${lexp_15} ) >=1
1 Yes
0 No
generated_note_name_1173 Start point L
Question relevant when: ${start_group_lexp} ='L'
Field Question Answer
lexp_17 (required) 17. Does the child initiate at least one interaction for play?
Materials: Objects of interest
Question relevant when: ${start_group_lexp} ='K' or ${start_group_lexp} ='L' or ( ${lexp_12} + ${lexp_13} +
${lexp_14} + ${lexp_15} + ${lexp_16} ) >=1
1 Yes
0 No
lexp_18 (required) 18. Does the child use at least two different words appropriately?
Materials: Objects of interest
1 Yes
0 No
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
55
Field Question Answer
Question relevant when: ${start_group_lexp} ='K' or ${start_group_lexp} ='L' or ( ${lexp_13} + ${lexp_14} +
${lexp_15} + ${lexp_16} + ${lexp_17} ) >=1
lexp_19 (required) 19. Does the child use at least one word to make wants known?
Question relevant when: ${start_group_lexp} ='L' or ( ${lexp_14} + ${lexp_15} + ${lexp_16} + ${lexp_17} +
${lexp_18} ) >=1
1 Yes
0 No
generated_note_name_1177 Start point M and N
Question relevant when: ${start_group_lexp} ='MN'
lexp_20 (required) 20. Does the child correctly name at least one object?
Materials: Story Book, Small ball, Doll, Spoon, and Plastic cup
Question relevant when: ${start_group_lexp} ='L' or ${start_group_lexp} ='MN' or ( ${lexp_15} + ${lexp_16} +
${lexp_17} + ${lexp_18} + ${lexp_19} ) >=1
1 Yes
0 No
lexp_21 (required) 21. Does the child use at least one word and gesture combination?
Question relevant when: ${start_group_lexp} ='L' or ${start_group_lexp} ='MN' or ( ${lexp_16} + ${lexp_17} +
${lexp_18} + ${lexp_19} + ${lexp_20} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (expressive comm) Language: Expressive Communication Subtest > gr_lexp_22
Group relevant when: ${start_group_lexp} ='MN' or ( ${lexp_17} + ${lexp_18} + ${lexp_19} + ${lexp_20} + ${lexp_21} ) >=1
note_lexp_22 22. Does the child correctly names the pictures?
Materials: Picture Book (pp. 10- 15)
1 Yes
0 No
lexp_item_22_1 (required) Biscuit
Question relevant when: ${pre_lexp_item_22_1} != null
1 Yes
0 No
lexp_item_22_2 (required) Bottle
Question relevant when: ${pre_lexp_item_22_2} != null
1 Yes
0 No
lexp_item_22_3 (required) Shoe(s)
Question relevant when: ${pre_lexp_item_22_3} != null
1 Yes
0 No
lexp_item_22_4 (required) Car
Question relevant when: ${pre_lexp_item_22_4} != null
1 Yes
0 No
lexp_item_22_5 (required) Bird
Question relevant when: ${pre_lexp_item_22_5} != null
1 Yes
0 No
lexp_item_22_6 (required) Balloon(s)
Question relevant when: ${pre_lexp_item_22_6} != null
1 Yes
0 No
lexp_item_22_7 (required) Bed
Question relevant when: ${pre_lexp_item_22_7} != null
1 Yes
0 No
lexp_item_22_8 (required) Kitten
Question relevant when: ${pre_lexp_item_22_8} != null
1 Yes
0 No
lexp_item_22_9 (required) Ball
Question relevant when: ${pre_lexp_item_22_9} != null
1 Yes
0 No
lexp_item_22_10 (required) Spoon
Question relevant when: ${pre_lexp_item_22_10} != null
1 Yes
0 No
lexp_item_22_11 (required) Banana
Question relevant when: ${pre_lexp_item_22_11} != null
1 Yes
0 No
lexp_item_22_12 (required) Book
Question relevant when: ${pre_lexp_item_22_12} != null
1 Yes
0 No
generated_note_name_1196 Start point O
Question relevant when: ${start_group_lexp} ='O'
lexp_23 (required) 23. Does the child use at least eight different words appropriately?
Materials: Objects of interest
Question relevant when: ${start_group_lexp} ='MN' or ${start_group_lexp} ='O' or ( ${lexp_18} + ${lexp_19} +
${lexp_20} + ${lexp_21} + ${lexp_22} ) >=1
1 Yes
0 No
lexp_24 (required) 24. Does the child use yes or no appropriately in at least two response?
Materials: Objects of interest
Question relevant when: ${start_group_lexp} ='MN' or ${start_group_lexp} ='O' or ( ${lexp_19} + ${lexp_20} +
${lexp_21} + ${lexp_22} + ${lexp_23} ) >=1
1 Yes
0 No
lexp_25 (required) 25. Does the child imitate a two-word or multiple-word utterance?
Question relevant when: ${start_group_lexp} ='O' or ( ${lexp_20} + ${lexp_21} + ${lexp_22} + ${lexp_23} +
${lexp_24} ) >=1
1 Yes
0 No
lexp_26 (required) 26. Does the child produce at least one utterance that includes two or more words, each of which denotes a different
concept?
1 Yes
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
56
Field Question Answer
Question relevant when: ${start_group_lexp} ='O' or ( ${lexp_21} + ${lexp_22} + ${lexp_23} + ${lexp_24} +
${lexp_25} ) >=1
0 No
generated_note_name_1201 Start point P
Question relevant when: ${start_group_lexp} ='P'
lexp_27 (required) 27. Does the child correctly name at least three objects?
Materials: Story Book, Small ball, Doll, Spoon, and Plastic cup
Question relevant when: ${start_group_lexp} ='O' or ${start_group_lexp} ='P' or ( ${lexp_22} + ${lexp_23} +
${lexp_24} + ${lexp_25} + ${lexp_26} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (expressive comm) Language: Expressive Communication Subtest > gr_lexp_28
Group relevant when: ${start_group_lexp} ='P' or ( ${lexp_23} + ${lexp_24} + ${lexp_25} + ${lexp_26} + ${lexp_27} ) >=1
note_lexp_28 28. Does the child correctly names the pictures?
Materials: Picture Book (pp.1O-15)
1 Yes
0 No
lexp_item_28_1 (required) Biscuit
Question relevant when: ${pre_lexp_item_28_1} != null
1 Yes
0 No
lexp_item_28_2 (required) Bottle
Question relevant when: ${pre_lexp_item_28_2} != null
1 Yes
0 No
lexp_item_28_3 (required) Shoe(s)
Question relevant when: ${pre_lexp_item_28_3} != null
1 Yes
0 No
lexp_item_28_4 (required) Truck
Question relevant when: ${pre_lexp_item_28_4} != null
1 Yes
0 No
lexp_item_28_5 (required) Bird
Question relevant when: ${pre_lexp_item_28_5} != null
1 Yes
0 No
lexp_item_28_6 (required) Balloon(s)
Question relevant when: ${pre_lexp_item_28_6} != null
1 Yes
0 No
lexp_item_28_7 (required) Bed
Question relevant when: ${pre_lexp_item_28_7} != null
1 Yes
0 No
lexp_item_28_8 (required) Kitten
Question relevant when: ${pre_lexp_item_28_8} != null
1 Yes
0 No
lexp_item_28_9 (required) Ball
Question relevant when: ${pre_lexp_item_28_9} != null
1 Yes
0 No
lexp_item_28_10 (required) Spoon
Question relevant when: ${pre_lexp_item_28_10} != null
1 Yes
0 No
lexp_item_28_11 (required) Banana
Question relevant when: ${pre_lexp_item_28_11} != null
1 Yes
0 No
lexp_item_28_12 (required) Book
Question relevant when: ${pre_lexp_item_28_12} != null
1 Yes
0 No
lexp_29 (required) 29. Does the child use at least two multiple-word utterances?
Question relevant when: ${start_group_lexp} ='P' or ( ${lexp_24} + ${lexp_25} + ${lexp_26} + ${lexp_27} +
${lexp_28} ) >=1
1 Yes
0 No
generated_note_name_1220 Start point Q
Question relevant when: ${start_group_lexp} ='Q'
lexp_30 (required) 30. Does the child use at least one pronoun?
Materials: Objects of interest
Question relevant when: ${start_group_lexp} ='P' or ${start_group_lexp} ='Q' or ( ${lexp_25} + ${lexp_26} +
${lexp_27} + ${lexp_28} + ${lexp_29} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (expressive comm) Language: Expressive Communication Subtest > gr_lexp_31
Group relevant when: ${start_group_lexp} ='P' or ${start_group_lexp} ='Q' or ( ${lexp_26} + ${lexp_27} + ${lexp_28} + ${lexp_29} + ${lexp_30} ) >=1
note_lexp_31 31. Does the child correctly name the action in at least one picture?
Materials: Picture Book (pp. 16-21)
1 Yes
0 No
lexp_item_31_1 (required) Eating
Question relevant when: ${pre_lexp_item_31_1} != null
1 Yes
0 No
lexp_item_31_2 (required) Hugging
Question relevant when: ${pre_lexp_item_31_2} != null
1 Yes
0 No
lexp_item_31_3 (required) Yawning
Question relevant when: ${pre_lexp_item_31_3} != null
1 Yes
0 No
lexp_item_31_4 (required) Playing 1 Yes
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
57
Field Question Answer
Question relevant when: ${pre_lexp_item_31_4} != null 0 No
lexp_item_31_5 (required) Running
Question relevant when: ${pre_lexp_item_31_5} != null
1 Yes
0 No
lexp_item_31_6 (required) Sweeping
Question relevant when: ${pre_lexp_item_31_6} != null
1 Yes
0 No
Field Question Answer
lexp_item_31_7 (required) Sleeping
Question relevant when: ${pre_lexp_item_31_7} != null
1 Yes
0 No
lexp_item_31_8 (required) Kicking
Question relevant when: ${pre_lexp_item_31_8} != null
1 Yes
0 No
lexp_item_31_9 (required) Washing clothes
Question relevant when: ${pre_lexp_item_31_9} != null
1 Yes
0 No
lexp_item_31_10 (required) Bathing
Question relevant when: ${pre_lexp_item_31_10} != null
1 Yes
0 No
lexp_item_31_11 (required) Climbing
Question relevant when: ${pre_lexp_item_31_11} != null
1 Yes
0 No
lexp_item_31_12 (required) Washing dishes
Question relevant when: ${pre_lexp_item_31_12} != null
1 Yes
0 No
lexp_32 (required) 32. Does the child pose at least one two-word or multiple-word question?
Question relevant when: ${start_group_lexp} ='Q' or ( ${lexp_27} + ${lexp_28} + ${lexp_29} + ${lexp_30} +
${lexp_31} ) >=1
1 Yes
0 No
lexp_33 (required) 33. Does the child produce at least one contingent utterance?
Question relevant when: ${start_group_lexp} ='Q' or ( ${lexp_28} + ${lexp_29} + ${lexp_30} + ${lexp_31} +
${lexp_32} ) >=1
1 Yes
0 No
lexp_34 (required) 34. Does the child use verb with -ing to describe at least one pictured action?
Materials: Stimulus Book (p.151)
Question relevant when: ${start_group_lexp} ='Q' or ( ${lexp_29} + ${lexp_30} + ${lexp_31} + ${lexp_32} +
${lexp_33} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (expressive comm) Language: Expressive Communication Subtest > gr_lexp_35
Group relevant when: ( ${lexp_30} + ${lexp_31} + ${lexp_32} + ${lexp_33} + ${lexp_34} ) >= 1
note_lexp_35 35. Does the child correctly name the action in the pictures?
Materials: Picture Book (pp. 16-21)
1 Yes
0 No
lexp_item_35_1 (required) Eating 1 Yes
0 No
lexp_item_35_2 (required) Hugging 1 Yes
0 No
lexp_item_35_3 (required) Yawning 1 Yes
0 No
lexp_item_35_4 (required) Playing 1 Yes
0 No
lexp_item_35_5 (required) Running 1 Yes
0 No
lexp_item_35_6 (required) Sweeping 1 Yes
0 No
lexp_item_35_7 (required) Sleeping 1 Yes
0 No
lexp_item_35_8 (required) Kicking 1 Yes
0 No
lexp_item_35_9 (required) Washing clothes 1 Yes
0 No
lexp_item_35_10 (required) Bathing 1 Yes
0 No
lexp_item_35_11 (required) Climbing 1 Yes
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Field Question Answer
0 No
lexp_item_35_12 (required) Washing dishes 1 Yes
0 No
Survey > Child Development Survey > (expressive comm) Language: Expressive Communication Subtest > gr_lexp_36
Group relevant when: ( ${lexp_31} + ${lexp_32} + ${lexp_33} + ${lexp_34} + ${lexp_35} ) >= 1
note_lexp_36 36. Does the child produce sentences matching the listed sentence structures? 1 Yes
0 No
lexp_item_36_1 (required) Noun + verb 1 Yes
0 No
lexp_item_36_2 (required) Noun + verb + location 1 Yes
0 No
lexp_item_36_3 (required) Verb + noun 1 Yes
0 No
Field Question Answer
lexp_item_36_4 (required) Noun + verb + adjective 1 Yes
0 No
lexp_item_36_5 (required) Adjective + noun 1 Yes
0 No
lexp_item_36_6 (required) Other 1 Yes
0 No
lexp_36f_specify (required) Specify the other sentence structures:
Question relevant when: ${lexp_item_36_6} =1
Response constrained to: string-length(.) > 3
Survey > Child Development Survey > (expressive comm) Language: Expressive Communication Subtest > gr_lexp_37
Group relevant when: ( ${lexp_32} + ${lexp_33} + ${lexp_34} + ${lexp_35} + ${lexp_36} ) >= 1
note_lexp_37 37. Does the child correctly name the action in the pictures?
Materials: Picture Book (pp. 16-21)
1 Yes
0 No
lexp_item_37_1 (required) Eating 1 Yes
0 No
lexp_item_37_2 (required) Hugging 1 Yes
0 No
lexp_item_37_3 (required) Yawning 1 Yes
0 No
lexp_item_37_4 (required) Playing 1 Yes
0 No
lexp_item_37_5 (required) Running 1 Yes
0 No
lexp_item_37_6 (required) Sweeping 1 Yes
0 No
lexp_item_37_7 (required) Sleeping 1 Yes
0 No
lexp_item_37_8 (required) Kicking 1 Yes
0 No
lexp_item_37_9 (required) Washing clothes 1 Yes
0 No
lexp_item_37_10 (required) Bathing 1 Yes
0 No
lexp_item_37_11 (required) Climbing 1 Yes
0 No
lexp_item_37_12 (required) Washing dishes 1 Yes
0 No
Survey > Child Development Survey > (expressive comm) Language: Expressive Communication Subtest > gr_lexp_38
Group relevant when: ( ${lexp_33} + ${lexp_34} + ${lexp_35} + ${lexp_36} + ${lexp_37} ) >= 1
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note_lexp_38 38. Does the child correctly use plural forms to name the pictures?
Materials: Stimulus Book (p. 153)
1 Yes
0 No
lexp_item_38_1 (required) Books 1 Yes
0 No
lexp_item_38_2 (required) Socks 1 Yes
0 No
lexp_item_38_3 (required) Bananas 1 Yes
0 No
lexp_item_38_4 (required) Shoes 1 Yes
0 No
lexp_item_38_5 (required) Bowls 1 Yes
0 No
lexp_item_38_6 (required) Zebras 1 Yes
0 No
lexp_item_38_7 (required) Babies 1 Yes
0 No
Survey > Child Development Survey > (expressive comm) Language: Expressive Communication Subtest > gr_lexp_39
Group relevant when: ( ${lexp_34} + ${lexp_35} + ${lexp_36} + ${lexp_37} + ${lexp_38} ) >= 1
note_lexp_39 39. Does the child correctly respond to the questions?
Materials: Stimulus Book (p. 155)
1 Yes
0 No
Field Question Answer
lexp_item_39_1 (required) What is he going to do? 1 Yes
0 No
lexp_item_39_2 (required) What does he have? 1 Yes
0 No
lexp_item_39_3 (required) Where is this boy? 1 Yes
0 No
lexp_40 (required) (40) 40. Does the child use a possessive pronoun or the 's ending?
Materials: Stimulus Book (p. 157)
Question relevant when: ( ${lexp_35} + ${lexp_36} + ${lexp_37} + ${lexp_38} + ${lexp_39} ) >= 1
1 Yes
0 No
Survey > Child Development Survey > (expressive comm) Language: Expressive Communication Subtest > gr_lexp_41
Group relevant when: ( ${lexp_36} + ${lexp_37} + ${lexp_38} + ${lexp_39} + ${lexp_40} ) >= 1
note_lexp_41 41. Does the child correctly name the colors?
Materials: Stimulus Book (p. 159)
1 Yes
0 No
lexp_item_41_1 (required) Red 1 Yes
0 No
lexp_item_41_2 (required) Yellow 1 Yes
0 No
lexp_item_41_3 (required) Brown 1 Yes
0 No
lexp_item_41_4 (required) Green 1 Yes
0 No
lexp_item_41_5 (required) White 1 Yes
0 No
lexp_item_41_6 (required) Purple 1 Yes
0 No
Survey > Child Development Survey > (expressive comm) Language: Expressive Communication Subtest > gr_lexp_42
Group relevant when: ( ${lexp_37} + ${lexp_38} + ${lexp_39} + ${lexp_40} + ${lexp_41} ) >= 1
note_lexp_42 42. Does the child give logical answers to the question …? 1 Yes
0 No
lexp_item_42_1 (required) Sleepy 1 Yes
0 No
lexp_item_42_2 (required) Dirty 1 Yes
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0 No
lexp_item_42_3 (required) Cold 1 Yes
0 No
Survey > Child Development Survey > (expressive comm) Language: Expressive Communication Subtest > gr_lexp_43
Group relevant when: ( ${lexp_38} + ${lexp_39} + ${lexp_40} + ${lexp_41} + ${lexp_42} ) >= 1
note_lexp_43 43. Does the child describe a logical function for the object …?
Materials: Picture Book (pp. 22-23)
1 Yes
0 No
lexp_item_43_1 (required) Cup 1 Yes
0 No
lexp_item_43_2 (required) Soap 1 Yes
0 No
lexp_item_43_3 (required) Shoes 1 Yes
0 No
lexp_item_43_4 (required) Knife 1 Yes
0 No
lexp_item_43_5 (required) Bicycle 1 Yes
0 No
lexp_44 (required) 44. Does the child correctly use at least two prepositions?
Materials: Spoon, and Plastic cup
Question relevant when: ( ${lexp_39} + ${lexp_40} + ${lexp_41} + ${lexp_42} + ${lexp_43} ) >= 1
1 Yes
0 No
lexp_45 (required) 45. Does the child use present progressive verb form in at least half of his or her spontaneous utterances that require
present progressive form?
Materials: Objects of interest
Question relevant when: ( ${lexp_40} + ${lexp_41} + ${lexp_42} + ${lexp_43} + ${lexp_44} ) >= 1
1 Yes
0 No
lexp_46 (required) 46. Ask the child to describe the pictures series.
Does the child use a four to five-word sentence at least twice during the testing time?
Materials: Stimulus Book (pp. 161- 169)
Question relevant when: ( ${lexp_41} + ${lexp_42} + ${lexp_43} + ${lexp_44} + ${lexp_45} ) >= 1
1 Yes
0 No
Field Question Answer
lexp_47 (required) 47. Ask the child to describe the pictures series using past tense.
Does the child use at least three past tense verbs?
Materials: Stimulus Book (pp . 161-169)
Question relevant when: ( ${lexp_42} + ${lexp_43} + ${lexp_44} + ${lexp_45} + ${lexp_46} ) >= 1
1 Yes
0 No
lexp_48 (required) 48. Ask the child to describe the pictures series using future tense.
Does the child use at least three instances of future tense?
Materials: Stimulus Book (pp.161-169)
Question relevant when: ( ${lexp_43} + ${lexp_44} + ${lexp_45} + ${lexp_46} + ${lexp_47} ) >= 1
1 Yes
0 No
generated_note_name_1339 We have finished with the Expressive Communication Subtest. Thank you. Now, I will move on to the next module.
Survey > Child Development Survey > determine_start_fmotor
Group relevant when: ${start_group_lexp} !=''
generated_note_name_1345 We have finished with the Expressive Communication Subtest.
Now, I'm going to ask you a couple of questions to determine where we should start the the fine motor subtest.
Survey > Child Development Survey > determine_start_fmotor > gr_start_q_fmotor
Group relevant when: ${month_calculate_str} >=39
generated_note_name_1348 Start point Q
pre_fmotor_43 (required) 43. Does the child produce a mostly curved shape?
Materials: 2 crayons, and Sheet of blank unlined white paper
1 Yes
0 No
pre_fmotor_44 (required) 44. Does the child place at least four blocks in a row?
Materials: 10 blocks
Question relevant when: ${pre_fmotor_43} =1
1 Yes
0 No
pre_fmotor_45 (required) 45. Does the child string at least three blocks on shoelace?
Materials: Shoelace, and 3 blocks with holes
Question relevant when: ${pre_fmotor_44} =1
1 Yes
0 No
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Survey > Child Development Survey > determine_start_fmotor > gr_start_p_fmotor
Group relevant when: ( ${month_calculate_str} >=33 and ${month_calculate_str} <39) or ${pre_fmotor_43} =0 or ${pre_fmotor_44} =0 or ${pre_fmotor_45} =0
generated_note_name_1357 Start point P
Survey > Child Development Survey > determine_start_fmotor > gr_start_p_fmotor > pre_gr_fmotor_38
pre_fmotor_38 (required) 38. Does the child stack at least six blocks?
Materials: 12 blocks
Trials: 3
1 Yes
0 No
pre_fmotor_38a (38a) Number of blocks in tallest tower:
pre_fmotor_39 (required) 39. Does the child hold paper in place with one hand while he or she scribbles or draws with the other?
Materials: Crayon or pencil, and Sheet of blank unlined white paper
Question relevant when: ${pre_fmotor_38} =1
1 Yes
0 No
pre_fmotor_40 (required) 40. Does the child's horizontal stroke is within approximately 30° of your horizontal line?
Materials: 2 crayons, and Sheet of blank unlined white paper
Question relevant when: ${pre_fmotor_39} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_fmotor > gr_start_o_fmotor
Group relevant when: ( ${month_calculate_str} >28.5 and ${month_calculate_str} <33) or ${pre_fmotor_38} =0 or ${pre_fmotor_39} =0 or ${pre_fmotor_40} =0
generated_note_name_1369 Start point O
pre_fmotor_35 (required) 35. Does the child place at least three coins into slot?
Materials: Bank, and 5 small coins (pennies, nickels, and/or dimes)
1 Yes
0 No
pre_fmotor_36 (required) 36. Does the child take all the blocks apart?
Materials: Connecting block set
Question relevant when: ${pre_fmotor_35} =1
1 Yes
0 No
pre_fmotor_37 (required) 37. Does the child grasp crayon or pencil using a static tripod (thumb and two fingers) or quadrupod (thumb and three
fingers) grasp while making a mark on the paper?
Materials: Crayon or pencil, and Sheet of blank unlined white paper
Question relevant when: ${pre_fmotor_36} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_fmotor > gr_start_mn_fmotor
Group relevant when: ( ${month_calculate_str} >22.5 and ${month_calculate_str} <=28.5) or ${pre_fmotor_35} =0 or ${pre_fmotor_36} =0 or ${pre_fmotor_37} =0
generated_note_name_1378 Start point M and N
Survey > Child Development Survey > determine_start_fmotor > gr_start_mn_fmotor > pre_gr_fmotor_31
pre_fmotor_31 (required) 31. Does the child stack at least two blocks?
Materials: 12 blocks
1 Yes
0 No
pre_fmotor_31a (31a) Number of blocks in tallest tower:
pre_fmotor_32 (required) 32. Does the child produce a stroke in any direction?
Materials: 2 crayons, and Sheet of blank unlined white paper
Question relevant when: ${pre_fmotor_31} =1
1 Yes
0 No
pre_fmotor_33 (required) 33. Does the child place 10 uncooked beans in bottle in 60 seconds or less, one uncooked bean at a time?
Materials: 12 uncooked beans, Bottle without lid, and Stopwatch
Time: 160 seconds
Question relevant when: ${pre_fmotor_32} =1
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > determine_start_fmotor > gr_start_kl_fmotor
Group relevant when: ( ${month_calculate_str} >13.5 and ${month_calculate_str} <=22.5) or ${pre_fmotor_31} =0 or ${pre_fmotor_32} =0 or ${pre_fmotor_33} =0
generated_note_name_1390 Start point K and L
pre_fmotor_28 (required) 28. Does the child grasp crayon or pencil using a palmar grasp while making a mark on the paper?
Materials: Crayon or pencil, and Sheet of blank unlined white paper
1 Yes
0 No
pre_fmotor_29 (required) 29. Does the child extend his or her index finger while keeping other fingers curled?
Materials: Pegboard
Question relevant when: ${pre_fmotor_28} =1 and ${month_calculate_str} >16.5
1 Yes
0 No
pre_fmotor_30 (required) 30. Does the child spontaneously and purposely scribble on the paper?
Materials: Crayon or pencil, and Sheet of blank unlined white paper
Question relevant when: ${pre_fmotor_29} =1 and ${month_calculate_str} >16.5
1 Yes
0 No
Survey > Child Development Survey > determine_start_fmotor > gr_start_j_fmotor
Group relevant when: ( ${month_calculate_str} >13.5 and ${month_calculate_str} <=16.5) or ${pre_fmotor_29} =0 or ${pre_fmotor_30} =0
generated_note_name_1400 Start point J
pre_fmotor_26 (required) 26. Does the child use pad of his or her thumb and any fingertip to grasp uncooked bean?
Materials: Uncooked bean
Question relevant when: ${pre_fmotor_28} =1
1 Yes
0 No
pre_fmotor_27 (required) 27. Does the child attempt to turn a page or several pages at once?
Materials: Picture Book
1 Yes
0 No
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Question relevant when: ${pre_fmotor_26} =1
Survey > Child Development Survey > determine_start_fmotor > gr_start_i_fmotor
Group relevant when: ( ${month_calculate_str} >=11 and ${month_calculate_str} <=13.5) or ${pre_fmotor_26} =0 or ${pre_fmotor_27} =0 or ${pre_fmotor_28} =0
generated_note_name_1408 Start point I
pre_fmotor_22 (required) 22. Does the child use pad of his or her thumb and any fingertip to grasp block?
Materials: Block without hole
Trials: 2
1 Yes
0 No
pre_fmotor_23 (required) 23. Does the child bring spoons or blocks together at his or her midline?
Materials: 2 spoons or 2 blocks without holes
Question relevant when: ${pre_fmotor_22} =1
1 Yes
0 No
pre_fmotor_24 (required) 24. Does the child grasp uncooked bean so that thumb is at least partially opposed to the fingers?
Materials: Uncooked bean
Question relevant when: ${pre_fmotor_23} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_fmotor > gr_start_h_fmotor
Group relevant when: ( ${month_calculate_str} >=9 and ${month_calculate_str} < 11) or ${pre_fmotor_22} =0 or ${pre_fmotor_23} =0 or ${pre_fmotor_24} =0
generated_note_name_1417 Start point H
pre_fmotor_19 (required) 19. Does the child transfer ring from hand to hand?
Materials: Ring (without string)
1 Yes
0 No
pre_fmotor_20 (required) 20. Does the child use his or her whole hand to grasp uncooked bean?
Materials: Uncooked beans
Question relevant when: ${pre_fmotor_19} =1
1 Yes
0 No
pre_fmotor_21 (required) 21. Does the child transfer block from hand to hand?
Materials: Block without hole
Question relevant when: ${pre_fmotor_20} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_fmotor > gr_start_g_fmotor
Group relevant when: ( ${month_calculate_str} >5.5 and ${month_calculate_str} <9) or ${pre_fmotor_19} =0 or ${pre_fmotor_20} =0 or ${pre_fmotor_21} =0
generated_note_name_1426 Start point G
pre_fmotor_15 (required) 15. Does the child pick up block using one or both hands?
Materials: Block without hole
Trials: 2
1 Yes
0 No
pre_fmotor_16 (required) 16. Does the child tend to reach with a single hand more often than with both hands?
Materials: Object of interest
Question relevant when: ${pre_fmotor_15} =1 and ${month_calculate_str} >6.5
1 Yes
0 No
pre_fmotor_17 (required) 17. Does the child rake at uncooked bean, attempting to grasp uncooked bean, even if he or she does not succeed in
grasping it?
Materials: Uncooked beans
Question relevant when: ${pre_fmotor_16} =1 and ${month_calculate_str} >6.5
1 Yes
0 No
Survey > Child Development Survey > determine_start_fmotor > gr_start_f_fmotor
Group relevant when: ( ${month_calculate_str} >5.5 and ${month_calculate_str} <=6.5) or ${pre_fmotor_16} =0 or ${pre_fmotor_17} =0
generated_note_name_1435 Start point F
pre_fmotor_13 (required) 13. Does the child extend one or both arms forward to reach block and does not have to grasp block?
Materials: Block without hole
Trials: 2
Question relevant when: ${pre_fmotor_15} =1
1 Yes
0 No
pre_fmotor_14 (required) 14. Does the child extend one or both arms forward and touches block with any part of either hand?
Materials: Block without hole
Trials: 2
Question relevant when: ${pre_fmotor_13} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_fmotor > gr_start_e_fmotor
Group relevant when: ( ${month_calculate_str} >4.5 and ${month_calculate_str} <=5.5) or ${pre_fmotor_13} =0 or ${pre_fmotor_14} =0 or ${pre_fmotor_15} =0
generated_note_name_1443 Start point E
Field Question Answer
pre_fmotor_10 (required) 10. Does the child hold his or her hands open most of the time when not attempting a task? 1 Yes
0 No
pre_fmotor_11 (required) 11. Does the child freely rotate wrist from palm down to palm up when manipulating a small object?
Materials: Block, rattle, bell, or other small object
Question relevant when: ${pre_fmotor_10} =1
1 Yes
0 No
pre_fmotor_12 (required) 12. Does the child use at least one hand to grasp ring for at least 2 seconds?
Materials: Ring with string
Trials: 2
Question relevant when: ${pre_fmotor_11} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_fmotor > gr_start_d_fmotor
Group relevant when: ( ${month_calculate_str} >3.5 and ${month_calculate_str} <=4.5) or ${pre_fmotor_10} =0 or ${pre_fmotor_11} =0 or ${pre_fmotor_12} =0
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generated_note_name_1452 Start point D
pre_fmotor_5 (required) 5. Does the child purposely attempt to place his or her hand in mouth? 1 Yes
0 No
pre_fmotor_6 (required) 6. Does the child retain ring for at least 2 seconds?
Materials: Ring with string
Question relevant when: ${pre_fmotor_5} =1
1 Yes
0 No
pre_fmotor_7 (required) 7. Does the child's eyes follow ring through one complete excursion (upper and lower halves of the circle)?
Materials: Ring with string
Trials: 3
Question relevant when: ${pre_fmotor_6} =1
1 Yes
0 No
generated_note_name_1463 [ENUMERATOR] Please contact your supervisor. We couldn't calculate the start point. Please, reschedule the
interview with [fullname_caregiver].
Question relevant when: ${start_group_fmotor} = ''
generated_note_name_1465 [ENUMERATOR] This child is performing below expectations for their age. If the child is distracted or not feeling well,
please take a break. Please also let your supervisor know that this child is having extreme difficulty.
Question relevant when: ${sum_passing_fmotor} > 2 and ${start_group_fmotor} != ''
failing_fmotor (required) Why is the child failing?
Question relevant when: ${sum_passing_fmotor} > 2
Response constrained to: string-length(.) > 3
Survey > Child Development Survey > (fine motor) Motor Scale: Fine Motor Subset
generated_note_name_1474 Fine Motor Subset
Thanks, now Im goint to start the Fine Motor Subset.
Question relevant when: ${start_group_fmotor} != ''
generated_note_name_1475 [ENUM]: Below, will appear some questions blocked, you have previously answered them to determine the starting
point.
Please, just click next.
Question relevant when: ${start_group_fmotor} != ''
generated_note_name_1477 Start point A, B and C
Question relevant when: ${start_group_fmotor} ='ABC'
fmotor_1 (required) 1. Does the child's hands are fisted a majority of the time?
Question relevant when: ${start_group_fmotor} ='ABC'
1 Yes
0 No
fmotor_2 (required) 2. Does the child's eyes follow moving person through midline to left and right?
Question relevant when: ${start_group_fmotor} ='ABC'
1 Yes
0 No
fmotor_3 (required) 3. Does the child's eyes follow ring through one complete excursion? (Horizontal)
Materials: Ring with string
Trials: 3
Question relevant when: ${start_group_fmotor} ='ABC'
1 Yes
0 No
fmotor_4 (required) 4. Does the child's eyes follow ring through one complete excursion? (Vertical)
Materials: Ring with string
Trials: 3
Question relevant when: ${start_group_fmotor} ='ABC'
1 Yes
0 No
generated_note_name_1482 Start point D
Question relevant when: ${start_group_fmotor} ='D'
fmotor_5 (required) 5. Does the child purposely attempt to place his or her hand in mouth?
Question relevant when: ${start_group_fmotor} ='ABC' or ${start_group_fmotor} ='D'
1 Yes
0 No
fmotor_6 (required) 6. Does the child retain ring for at least 2 seconds?
Materials: Ring with string
Question relevant when: ${start_group_fmotor} ='D' or ( ${fmotor_1} + ${fmotor_2} + ${fmotor_3} + ${fmotor_4} +
${fmotor_5} ) >=1
1 Yes
0 No
fmotor_7 (required) 7. Does the child's eyes follow ring through one complete excursion (upper and lower halves of the circle)?
Materials: Ring with string
Trials: 3
Question relevant when: ${start_group_fmotor} ='D' or ( ${fmotor_2} + ${fmotor_3} + ${fmotor_4} + ${fmotor_5} +
${fmotor_6} ) >=1
1 Yes
0 No
fmotor_8 (required) 8. Does the child turn his or her head to follow ring through one complete excursion?
Materials: Ring with string
Trials: 3
1 Yes
0 No
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Question relevant when: ${start_group_fmotor} ='D' or ( ${fmotor_3} + ${fmotor_4} + ${fmotor_5} + ${fmotor_6} +
${fmotor_7} ) >=1
fmotor_9 (required) 9. Does the child's eyes follow ball as it moves past midline on both sides?
Materials: Small ball
Question relevant when: ${start_group_fmotor} ='D' or ( ${fmotor_4} + ${fmotor_5} + ${fmotor_6} + ${fmotor_7} +
${fmotor_8} ) >=1
1 Yes
0 No
generated_note_name_1488 Start point E
Question relevant when: ${start_group_fmotor} ='E'
fmotor_10 (required) 10. Does the child hold his or her hands open most of the time when not attempting a task?
Question relevant when: ${start_group_fmotor} ='E' or ( ${fmotor_5} + ${fmotor_6} + ${fmotor_7} + ${fmotor_8} +
${fmotor_9} ) >=1
1 Yes
0 No
fmotor_11 (required) 11. Does the child freely rotate wrist from palm down to palm up when manipulating a small object?
Materials: Block, rattle, bell, or other small object
Question relevant when: ${start_group_fmotor} ='E' or ( ${fmotor_6} + ${fmotor_7} + ${fmotor_8} + ${fmotor_9} +
${fmotor_10} ) >=1
1 Yes
0 No
fmotor_12 (required) 12. Does the child use at least one hand to grasp ring for at least 2 seconds?
Materials: Ring with string
Trials: 2
Question relevant when: ${start_group_fmotor} ='E' or ( ${fmotor_7} + ${fmotor_8} + ${fmotor_9} + ${fmotor_10} +
${fmotor_11} ) >=1
1 Yes
0 No
generated_note_name_1492 Start point F
Question relevant when: ${start_group_fmotor} ='F'
fmotor_13 (required) 13. Does the child extend one or both arms forward to reach block and does not have to grasp block?
Materials: Block without hole
Trials: 2
Question relevant when: ${start_group_fmotor} ='E' or ${start_group_fmotor} ='F' or ( ${fmotor_8} + ${fmotor_9} +
${fmotor_10} + ${fmotor_11} + ${fmotor_12} ) >=1
1 Yes
0 No
fmotor_14 (required) 14. Does the child extend one or both arms forward and touches block with any part of either hand?
Materials: Block without hole
Trials: 2
Question relevant when: ${start_group_fmotor} ='E' or ${start_group_fmotor} ='F' or ( ${fmotor_9} + ${fmotor_10} +
${fmotor_11} + ${fmotor_12} + ${fmotor_13} ) >=1
1 Yes
0 No
generated_note_name_1495 Start point G
Question relevant when: ${start_group_fmotor} ='G'
fmotor_15 (required) 15. Does the child pick up block using one or both hands?
Materials: Block without hole
Trials: 2
Question relevant when: ${start_group_fmotor} ='F' or ${start_group_fmotor} ='G' or ( ${fmotor_10} + ${fmotor_11}
+ ${fmotor_12} + ${fmotor_13} + ${fmotor_14} ) >=1
1 Yes
0 No
fmotor_16 (required) 16. Does the child tend to reach with a single hand more often than with both hands?
Materials: Object of interest
Question relevant when: ${start_group_fmotor} ='F' or ${start_group_fmotor} ='G' or ( ${fmotor_11} + ${fmotor_12}
+ ${fmotor_13} + ${fmotor_14} + ${fmotor_15} ) >=1
1 Yes
0 No
fmotor_17 (required) 17. Does the child rake at uncooked bean, attempting to grasp uncooked bean, even if he or she does not succeed in
grasping it?
Materials: Uncooked beans
Question relevant when: ${start_group_fmotor} ='F' or ${start_group_fmotor} ='G' or ( ${fmotor_12} + ${fmotor_13}
+ ${fmotor_14} + ${fmotor_15} + ${fmotor_16} ) >=1
1 Yes
0 No
fmotor_18 (required) 18. Does the child grasp block so that thumb is partially opposed to the fingers?
Materials: Block without hole
Trials: 2
Question relevant when: ${start_group_fmotor} ='G' or ( ${fmotor_13} + ${fmotor_14} + ${fmotor_15} +
${fmotor_16} + ${fmotor_17} ) >=1
1 Yes
0 No
generated_note_name_1500 Start point H
Question relevant when: ${start_group_fmotor} ='H'
fmotor_19 (required) 19. Does the child transfer ring from hand to hand?
Materials: Ring (without string)
Question relevant when: ${start_group_fmotor} ='G' or ${start_group_fmotor} ='H' or ( ${fmotor_14} + ${fmotor_15}
+ ${fmotor_16} + ${fmotor_17} + ${fmotor_18} ) >=1
1 Yes
0 No
fmotor_20 (required) 20. Does the child use his or her whole hand to grasp uncooked bean?
Materials: Uncooked beans
Question relevant when: ${start_group_fmotor} ='H' or ( ${fmotor_15} + ${fmotor_16} + ${fmotor_17} +
${fmotor_18} + ${fmotor_19} ) >=1
1 Yes
0 No
fmotor_21 (required) 21. Does the child transfer block from hand to hand?
Materials: Block without hole
Question relevant when: ${start_group_fmotor} ='H' or ( ${fmotor_16} + ${fmotor_17} + ${fmotor_18} +
${fmotor_19} + ${fmotor_20} ) >=1
1 Yes
0 No
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Field Question Answer
generated_note_name_1504 Start point I
Question relevant when: ${start_group_fmotor} ='I'
fmotor_22 (required) 22. Does the child use pad of his or her thumb and any fingertip to grasp block?
Materials: Block without hole
Trials: 2
1 Yes
0 No
Field Question Answer
Question relevant when: ${start_group_fmotor} ='H' or ${start_group_fmotor} ='I' or ( ${fmotor_17} + ${fmotor_18}
+ ${fmotor_19} + ${fmotor_20} + ${fmotor_21} ) >=1
fmotor_23 (required) 23. Does the child bring spoons or blocks together at his or her midline?
Materials: 2 spoons or 2 blocks without holes
Question relevant when: ${start_group_fmotor} ='H' or ${start_group_fmotor} ='I' or ( ${fmotor_18} + ${fmotor_19}
+ ${fmotor_20} + ${fmotor_21} + ${fmotor_22} ) >=1
1 Yes
0 No
fmotor_24 (required) 24. Does the child grasp uncooked bean so that thumb is at least partially opposed to the fingers?
Materials: Uncooked bean
Question relevant when: ${start_group_fmotor} ='I' or ( ${fmotor_19} + ${fmotor_20} + ${fmotor_21} +
${fmotor_22} + ${fmotor_23} ) >=1
1 Yes
0 No
fmotor_25 (required) 25. Does the child lift cup by handle using one hand?
Materials: Cup with handle
Question relevant when: ${start_group_fmotor} ='I' or ( ${fmotor_20} + ${fmotor_21} + ${fmotor_22} +
${fmotor_23} + ${fmotor_24} ) >=1
1 Yes
0 No
generated_note_name_1509 Start point J
Question relevant when: ${start_group_fmotor} ='J'
fmotor_26 (required) 26. Does the child use pad of his or her thumb and any fingertip to grasp uncooked bean?
Materials: Uncooked bean
Question relevant when: ${start_group_fmotor} ='I' or ${start_group_fmotor} ='J' or ( ${fmotor_21} + ${fmotor_22}
+ ${fmotor_23} + ${fmotor_24} + ${fmotor_25} ) >=1
1 Yes
0 No
fmotor_27 (required) 27. Does the child attempt to turn a page or several pages at once?
Materials: Picture Book
Question relevant when: ${start_group_fmotor} ='J' or ( ${fmotor_22} + ${fmotor_23} + ${fmotor_24} +
${fmotor_25} + ${fmotor_26} ) >=1
1 Yes
0 No
generated_note_name_1513 Start point K and L
Question relevant when: ${start_group_fmotor} ='KL'
fmotor_28 (required) 28. Does the child grasp crayon or pencil using a palmar grasp while making a mark on the paper?
Materials: Crayon or pencil, and Sheet of blank unlined white paper
Question relevant when: ${start_group_fmotor} ='J' or ${start_group_fmotor} ='KL' or ( ${fmotor_23} +
${fmotor_24} + ${fmotor_25} + ${fmotor_26} + ${fmotor_27} ) >=1
1 Yes
0 No
fmotor_29 (required) 29. Does the child extend his or her index finger while keeping other fingers curled?
Materials: Pegboard
Question relevant when: ${start_group_fmotor} ='J' or ${start_group_fmotor} ='KL' or ( ${fmotor_24} +
${fmotor_25} + ${fmotor_26} + ${fmotor_27} + ${fmotor_28} ) >=1
1 Yes
0 No
fmotor_30 (required) 30. Does the child spontaneously and purposely scribble on the paper?
Materials: Crayon or pencil, and Sheet of blank unlined white paper
Question relevant when: ${start_group_fmotor} ='J' or ${start_group_fmotor} ='KL' or ( ${fmotor_25} +
${fmotor_26} + ${fmotor_27} + ${fmotor_28} + ${fmotor_29} ) >=1
1 Yes
0 No
generated_note_name_1517 Start point M and N
Question relevant when: ${start_group_fmotor} ='MN'
Survey > Child Development Survey > (fine motor) Motor Scale: Fine Motor Subset > gr_fmotor_31
Group relevant when: ${start_group_fmotor} ='KL' or ${start_group_fmotor} ='MN' or ( ${fmotor_26} + ${fmotor_27} + ${fmotor_28} + ${fmotor_29} + ${fmotor_30} ) >=1
fmotor_31 (required) 31. Does the child stack at least two blocks?
Materials: 12 blocks
Question relevant when: ${pre_fmotor_31} != null
1 Yes
0 No
fmotor_31a (31a) Number of blocks in tallest tower:
Question relevant when: ${pre_fmotor_31a} != null
fmotor_32 (required) 32. Does the child produce a stroke in any direction?
Materials: 2 crayons, and Sheet of blank unlined white paper
Question relevant when: ${start_group_fmotor} ='KL' or ${start_group_fmotor} ='MN' or ( ${fmotor_27} +
${fmotor_28} + ${fmotor_29} + ${fmotor_30} + ${fmotor_31} ) >=1
1 Yes
0 No
fmotor_33 (required) 33. Does the child place 10 uncooked beans in bottle in 60 seconds or less, one uncooked bean at a time?
Materials: 12 Uncooked beans, Bottle without lid, and Stopwatch
Time: 160 seconds
1 Yes
0 No
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Field Question Answer
Question relevant when: ${start_group_fmotor} ='MN' or ( ${fmotor_28} + ${fmotor_29} + ${fmotor_30} +
${fmotor_31} + ${fmotor_32} ) >=1
fmotor_34 (required) 34. Does the child grasp crayon or pencil using fingers and partial thumb opposition while making a mark on the
paper?
Materials: Crayon or pencil, and Sheet of blank unlined white paper
Question relevant when: ${start_group_fmotor} ='MN' or ( ${fmotor_29} + ${fmotor_30} + ${fmotor_31} +
${fmotor_32} + ${fmotor_33} ) >=1
1 Yes
0 No
generated_note_name_1525 Start point O
Question relevant when: ${start_group_fmotor} ='O'
fmotor_35 (required) 35. Does the child place at least three coins into slot?
Materials: Bank, and 5 small coins (pennies, nickels, and/or dimes)
Question relevant when: ${start_group_fmotor} ='MN' or ${start_group_fmotor} ='O' or ( ${fmotor_30} +
${fmotor_31} + ${fmotor_32} + ${fmotor_33} + ${fmotor_34} ) >=1
1 Yes
0 No
fmotor_36 (required) 36. Does the child take all the blocks apart? 1 Yes
Field Question Answer
Materials: Connecting block set
Question relevant when: ${start_group_fmotor} ='O' or ( ${fmotor_31} + ${fmotor_32} + ${fmotor_33} +
${fmotor_34} + ${fmotor_35} ) >=1
0 No
fmotor_37 (required) 37. Does the child grasp crayon or pencil using a static tripod (thumb and two fingers) or quadrupod (thumb and three
fingers) grasp while making a mark on the paper?
Materials: Crayon or pencil, and Sheet of blank unlined white paper
Question relevant when: ${start_group_fmotor} ='O' or ( ${fmotor_32} + ${fmotor_33} + ${fmotor_34} +
${fmotor_35} + ${fmotor_36} ) >=1
1 Yes
0 No
generated_note_name_1529 Start point P
Question relevant when: ${start_group_fmotor} ='P'
Survey > Child Development Survey > (fine motor) Motor Scale: Fine Motor Subset > gr_fmotor_38
Group relevant when: ${start_group_fmotor} ='O' or ${start_group_fmotor} ='P' or ( ${fmotor_33} + ${fmotor_34} + ${fmotor_35} + ${fmotor_36} + ${fmotor_37} ) >=1
fmotor_38 (required) 38. Does the child stack at least six blocks?
Materials: 12 blocks
Trials: 3
Question relevant when: ${pre_fmotor_38} != null
1 Yes
0 No
fmotor_38a (38a) Number of blocks in tallest tower:
Question relevant when: ${pre_fmotor_38a} != null
fmotor_39 (required) 39. Does the child hold paper in place with one hand while he or she scribbles or draws with the other?
Materials: Crayon or pencil, and Sheet of blank unlined white paper
Question relevant when: ${start_group_fmotor} ='O' or ${start_group_fmotor} ='P' or ( ${fmotor_34} + ${fmotor_35}
+ ${fmotor_36} + ${fmotor_37} + ${fmotor_38} ) >=1
1 Yes
0 No
fmotor_40 (required) 40. Does the child's horizontal stroke is within approximately 30° of your horizontal line?
Materials: 2 crayons, and Sheet of blank unlined white paper
Question relevant when: ${start_group_fmotor} ='P' or ( ${fmotor_35} + ${fmotor_36} + ${fmotor_37} +
${fmotor_38} + ${fmotor_39} ) >=1
1 Yes
0 No
fmotor_41 (required) 41. Does the child's vertical stroke is within approximately 30° of your vertical line?
Materials: 2 crayons, and Sheet of blank unlined white paper
Question relevant when: ${start_group_fmotor} ='P' or ( ${fmotor_36} + ${fmotor_37} + ${fmotor_38} +
${fmotor_39} + ${fmotor_40} ) >=1
1 Yes
0 No
fmotor_42 (required) 42. Does the child put all the blocks together. At least two connector knobs on each block should be correctly aligned
and secured to another block?
Materials: Connecting block set
Question relevant when: ${start_group_fmotor} ='P' or ( ${fmotor_37} + ${fmotor_38} + ${fmotor_39} +
${fmotor_40} + ${fmotor_41} ) >=1
1 Yes
0 No
generated_note_name_1538 Start point Q
Question relevant when: ${start_group_fmotor} ='Q'
fmotor_43 (required) 43. Does the child produce a mostly curved shape?
Materials: 2 crayons, and Sheet of blank unlined white paper
Question relevant when: ${start_group_fmotor} ='Q' or ( ${fmotor_38} + ${fmotor_39} + ${fmotor_40} +
${fmotor_41} + ${fmotor_42} ) >=1
1 Yes
0 No
fmotor_44 (required) 44. Does the child place at least four blocks in a row?
Materials: 10 blocks
Question relevant when: ${start_group_fmotor} ='Q' or ( ${fmotor_39} + ${fmotor_40} + ${fmotor_41} +
${fmotor_42} + ${fmotor_43} ) >=1
1 Yes
0 No
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Field Question Answer
fmotor_45 (required) 45. Does the child string at least three blocks on shoelace?
Materials: Shoelace, and 3 blocks with holes
Question relevant when: ${start_group_fmotor} ='Q' or ( ${fmotor_40} + ${fmotor_41} + ${fmotor_42} +
${fmotor_43} + ${fmotor_44} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (fine motor) Motor Scale: Fine Motor Subset > gr_fmotor_46
Group relevant when: ${start_group_fmotor} ='Q' or ( ${fmotor_41} + ${fmotor_42} + ${fmotor_43} + ${fmotor_44} + ${fmotor_45} ) >=1
note_fmotor_46 46. Does the child correctly imitate the positions?
For Position 3, child must make circular movements but need not move his or her hands in the same directions that you
demonstrate.
1 Yes
0 No
fmotor_item_46_1 (required) Position 1 1 Yes
0 No
fmotor_item_46_2 (required) Position 2 1 Yes
0 No
fmotor_item_46_3 (required) Position 3 1 Yes
0 No
fmotor_47 (required) 47. Does the child make two snips at least 1/2 inch long?
Materials: 2 blank index cards (3" x 5"), and Safety scissors
Question relevant when: ${start_group_fmotor} ='Q' or ( ${fmotor_42} + ${fmotor_43} + ${fmotor_44} +
${fmotor_45} + ${fmotor_46} ) >=1
1 Yes
0 No
fmotor_48 (required) 48. Does the child grasp crayon or pencil using a mature, controlled, dynamic grasp while making a mark on the
paper?
Materials: Crayon or pencil, and Sheet of blank unlined white paper
Question relevant when: ( ${fmotor_43} + ${fmotor_44} + ${fmotor_45} + ${fmotor_46} + ${fmotor_47} ) >= 1
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > (fine motor) Motor Scale: Fine Motor Subset > gr_fmotor_49
Group relevant when: ( ${fmotor_44} + ${fmotor_45} + ${fmotor_46} + ${fmotor_47} + ${fmotor_48} ) >= 1
note_fmotor_49 49. Does the child correctly identify the objects?
Materials: 2 yellow pegs, 2 blocks without holes, 2 blue square pieces, and Drawstring bag
1 Yes
0 No
fmotor_item_49_1 (required) Peg 1 Yes
0 No
fmotor_item_49_2 (required) Block 1 Yes
0 No
fmotor_item_49_3 (required) Square 1 Yes
0 No
fmotor_50 (required) 50. Does the child replicate wall?
Materials: 8 blocks
Question relevant when: ( ${fmotor_45} + ${fmotor_46} + ${fmotor_47} + ${fmotor_48} + ${fmotor_49} ) >= 1
1 Yes
0 No
fmotor_51 (required) 51. Does the child cut index card in half or makes a cut that is approximately four or more inches long?
Materials: 2 blank index cards (3" x 5"), and Safety scissors
Question relevant when: ( ${fmotor_46} + ${fmotor_47} + ${fmotor_48} + ${fmotor_49} + ${fmotor_50} ) >= 1
1 Yes
0 No
fmotor_52 (required) 52. Does the child replicate bridge?
Materials: 6 blocks
Question relevant when: ( ${fmotor_47} + ${fmotor_48} + ${fmotor_49} + ${fmotor_50} + ${fmotor_51} ) >= 1
1 Yes
0 No
fmotor_53 (required) 53. Does the child produce two intersecting lines; one is within 30° of horizontal and one is within 30° of vertical?
Materials: Crayon or pencil, and Sheet of blank unlined white paper
Question relevant when: ( ${fmotor_48} + ${fmotor_49} + ${fmotor_50} + ${fmotor_51} + ${fmotor_52} ) >= 1
1 Yes
0 No
Survey > Child Development Survey > (fine motor) Motor Scale: Fine Motor Subset > gr_fmotor_54
Group relevant when: ( ${fmotor_49} + ${fmotor_50} + ${fmotor_51} + ${fmotor_52} + ${fmotor_53} ) >= 1
fmotor_54 (required) 54. Does the child stack at least eight blocks?
Materials: 12 blocks
Trials: 3
1 Yes
0 No
fmotor_54a (54a) Number of blocks in tallest tower:
fmotor_55 (required) 55. Does the child cut index card along the line to make a cut that is approximately four or more inches long, within 1/2
inch of the line?
Materials: 2 blank index cards (3" x 5"), and Safety scissors Crayon or pencil
Question relevant when: ( ${fmotor_50} + ${fmotor_51} + ${fmotor_52} + ${fmotor_53} + ${fmotor_54} ) >= 1
1 Yes
0 No
fmotor_56 (required) 56. Does the child replicate T?
Materials: 10 blocks
Question relevant when: ( ${fmotor_51} + ${fmotor_52} + ${fmotor_53} + ${fmotor_54} + ${fmotor_55} ) >= 1
1 Yes
0 No
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Field Question Answer
fmotor_57 (required) 57. Does the child button sleeve?
Materials: Button sleeve
Question relevant when: ( ${fmotor_52} + ${fmotor_53} + ${fmotor_54} + ${fmotor_55} + ${fmotor_56} ) >= 1
1 Yes
0 No
fmotor_58 (required) 58. Does the child replicate steps?
Materials: 12 blocks
Question relevant when: ( ${fmotor_53} + ${fmotor_54} + ${fmotor_55} + ${fmotor_56} + ${fmotor_57} ) >= 1
1 Yes
0 No
fmotor_59 (required) 59. Does the child correctly trace at least two designs?
Materials: Pencil, Traces Designs Sheet (in Record Form)
Question relevant when: ( ${fmotor_54} + ${fmotor_55} + ${fmotor_56} + ${fmotor_57} + ${fmotor_58} ) >= 1
1 Yes
0 No
fmotor_60 (required) 60. Does the child produce a four-sided figure with four distinct corners and gaps no larger than 1/4 inch at the
corners?
Materials: Crayon or pencil, and Sheet of blank unlined white paper
Question relevant when: ( ${fmotor_55} + ${fmotor_56} + ${fmotor_57} + ${fmotor_58} + ${fmotor_59} ) >= 1
1 Yes
0 No
fmotor_61 (required) 61. Does the child produce two intersecting lines; one is within 30° of horizontal and one is within 30° of vertical?
Materials: Crayon or pencil, Copies Designs, and Sheet with
plus sign (in Record Form)
Question relevant when: ( ${fmotor_56} + ${fmotor_57} + ${fmotor_58} + ${fmotor_59} + ${fmotor_60} ) >= 1
1 Yes
0 No
fmotor_62 (required) 62. Does the child tap at least 20 times within 15 seconds for both hands?
Materials: Stopwatch
Time: 15 seconds
Question relevant when: ( ${fmotor_57} + ${fmotor_58} + ${fmotor_59} + ${fmotor_60} + ${fmotor_61} ) >= 1
1 Yes
0 No
fmotor_63 (required) 63. Does the child place 20 uncooked beans in bottle within 15 seconds, one uncooked bean at a time?
Materials: Uncooked beans, Bottle (without lid), and Stopwatch
Time: 15 seconds
Question relevant when: ( ${fmotor_58} + ${fmotor_59} + ${fmotor_60} + ${fmotor_61} + ${fmotor_62} ) >= 1
1 Yes
0 No
fmotor_64 (required) 64. Does the child cut out circle within 1/2 inch of the line?
Materials: Safety scissors, Cuts Designs Sheet, and Stopwatch
Time: 60 seconds
Question relevant when: ( ${fmotor_59} + ${fmotor_60} + ${fmotor_61} + ${fmotor_62} + ${fmotor_63} ) >= 1
1 Yes
0 No
fmotor_65 (required) 65. Does the child cut out square within 1/2 inch of the line?
Materials: Safety scissors, Cuts Designs Sheet, and Stopwatch
Time: 60 seconds
Question relevant when: ( ${fmotor_60} + ${fmotor_61} + ${fmotor_62} + ${fmotor_63} + ${fmotor_64} ) >= 1
1 Yes
0 No
fmotor_66 (required) 66. Does the child produce afour-sided figure with four distinct corners and gaps no larger than 1/4 inch at the
corners?
Materials: Crayon or pencil, and Copies Designs, Sheet with square (in Record Form)
Question relevant when: ( ${fmotor_61} + ${fmotor_62} + ${fmotor_63} + ${fmotor_64} + ${fmotor_65} ) >= 1
1 Yes
0 No
Survey > Child Development Survey > determine_start_gmotor
Field Question Answer
Group relevant when: ${start_group_fm generated_note_name_1589 otor} !=
We have finished with the Fine Motor Subset.
Now, I'm going to ask you a couple of questions to determine where we should start the the gross motor subtest.
Survey > Child Development Survey > determine_start_gmotor > gr_start_q_gmotor
Group relevant when: ${month_calculate_str} >=39
generated_note_name_1592 Start point Q
pre_gmotor_57 (required) 57. Does the child walk up three steps without using wall or handrail for support and place both feet on each step
before stepping up to the next?
Materials: Stairs
1 Yes
0 No
pre_gmotor_58 (required) 58. Does the child walks down three steps without using wall or handrail for support and place both feet on each step
before stepping up to the next?
Materials: Stairs
Question relevant when: ${pre_gmotor_57} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_gmotor > gr_start_q_gmotor > pre_gr_gmotor_59
Group relevant when: ${pre_gmotor_58} =1
pre_gmotor_59 (required) 59. Does the child jumps at least 4 inches in any trial?
Materials: Stepping path
Trials: 3
1 Yes
0 No
pre_gmotor_59a (59a) Trial 1 - Distance:
pre_gmotor_59b (59b) Trial 2 - Distance:
pre_gmotor_59c (59c) Trial 3 - Distance:
Survey > Child Development Survey > determine_start_gmotor > gr_start_p_gmotor
Group relevant when: ( ${month_calculate_str} >=33 and ${month_calculate_str} <39) or ${pre_gmotor_57} =0 or ${pre_gmotor_58} =0 or ${pre_gmotor_59} =0
generated_note_name_1606 Start point P
pre_gmotor_54 (required) 54. Does the child jump to floor? 1 Yes
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Field Question Answer
Materials: Stairs 0 No
pre_gmotor_55 (required) 55. Does the child maintain balance while kicking ball in aforward direction at least 6 cm. (2 feet)?
Materials: Large ball
Trials: 3
Question relevant when: ${pre_gmotor_54} =1
1 Yes
0 No
pre_gmotor_56 (required) 56. Does the child walk with at least one foot (i .e., left foot or right foot) on path for at least 1.5 meters (5 feet)?
Materials: Stepping path
Question relevant when: ${pre_gmotor_55} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_gmotor > gr_start_o_gmotor
Group relevant when: ( ${month_calculate_str} >28.5 and ${month_calculate_str} <33) or ${pre_gmotor_54} =0 or ${pre_gmotor_55} =0 or ${pre_gmotor_56} =0
generated_note_name_1615 Start point O
Survey > Child Development Survey > determine_start_gmotor > gr_start_o_gmotor > pre_gr_gmotor_51
pre_gmotor_51 (required) 51. Does the child balance on right foot while you hold one of his or her hands?
Materials: Stopwatch
1 Yes
0 No
pre_gmotor_51a (51a) Elapsed time with support:
pre_gmotor_51b (51b) Elapsed time without support:
Survey > Child Development Survey > determine_start_gmotor > gr_start_o_gmotor > pre_gr_gmotor_52
Group relevant when: ${pre_gmotor_51} =1
pre_gmotor_52 (required) 52. Does the child balance on left foot whi le you ho ld one of his or her hands?
Materials: Stopwatch
1 Yes
0 No
pre_gmotor_52a (52a) Elapsed time with support:
pre_gmotor_52b (52b) Elapsed time without support:
pre_gmotor_53 (required) 53. Does the child take at least two steps sideways without support?
Question relevant when: ${pre_gmotor_52} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_gmotor > gr_start_mn_gmotor
Group relevant when: ( ${month_calculate_str} >22.5 and ${month_calculate_str} <=28.5) or ${pre_gmotor_51} =0 or ${pre_gmotor_52} =0 or ${pre_gmotor_53} =0
generated_note_name_1632 Start point M and N
pre_gmotor_48 (required) 48. Does the child take at least two steps backward unassisted? 1 Yes
0 No
pre_gmotor_49 (required) 49. Does the child walk down at least three steps, using wall or handrail for support and child places both feet on each
step before stepping down to the next?
Materials: Stairs
Question relevant when: ${pre_gmotor_48} =1
1 Yes
0 No
pre_gmotor_50 (required) 50. Does the child run with good coordination?
Materials: Large ball
Question relevant when: ${pre_gmotor_49} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_gmotor > gr_start_l_gmotor
Group relevant when: ( ${month_calculate_str} >19.5 and ${month_calculate_str} <=22.5) or ${pre_gmotor_48} =0 or ${pre_gmotor_49} =0 or ${pre_gmotor_50} =0
generated_note_name_1641 Start point L
pre_gmotor_45 (required) 45. Does the child move from standing to squatting to standing while maintaining balance without using any support? 1 Yes
Field Question Answer
Materials: Object of interest 0 No
pre_gmotor_46 (required) 46. Does the child roll to one side and stands without using any support?
Question relevant when: ${pre_gmotor_45} =1
1 Yes
0 No
pre_gmotor_47 (required) 47. Does the child walk up at least three steps, using wall or handrail for support and place both feet on each step
before stepping up to the next?
Materials: Stairs
Question relevant when: ${pre_gmotor_46} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_gmotor > gr_start_k_gmotor
Group relevant when: ( ${month_calculate_str} >16.5 and ${month_calculate_str} <=19.5) or ${pre_gmotor_45} =0 or ${pre_gmotor_46} =0 or ${pre_gmotor_47} =0
generated_note_name_1650 Start point K
pre_gmotor_42 (required) 42. Does the child take at least three steps without support, even if gait is stiff-legged and wobbly? 1 Yes
0 No
pre_gmotor_43 (required) 43. Does the child take at least five steps independently, displaying coordination and balance?
Question relevant when: ${pre_gmotor_42} =1
1 Yes
0 No
pre_gmotor_44 (required) 44. Does the child purposely throws ball forward?
Materials: Small ball
1 Yes
0 No
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Field Question Answer
Question relevant when: ${pre_gmotor_43} =1
Survey > Child Development Survey > determine_start_gmotor > gr_start_j_gmotor
Group relevant when: ( ${month_calculate_str} >13.5 and ${month_calculate_str} <=16.5) or ${pre_gmotor_42} =0 or ${pre_gmotor_43} =0 or ${pre_gmotor_44} =0
generated_note_name_1659 Start point J
pre_gmotor_39 (required) 39. Does the child purposely lower from a standing to a sitting position in a controlled manner? 1 Yes
0 No
pre_gmotor_40 (required) 40. Does the child stand alone for at least 3 seconds after you release his or her hands?
Question relevant when: ${pre_gmotor_39} =1
1 Yes
0 No
pre_gmotor_41 (required) 41. Does the child come to a standing position, rolling first to a prone or quadruped position, without using any
support?
Question relevant when: ${pre_gmotor_40} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_gmotor > gr_start_i_gmotor
Group relevant when: ( ${month_calculate_str} >=11 and ${month_calculate_str} <=13.5) or ${pre_gmotor_39} =0 or ${pre_gmotor_40} =0 or ${pre_gmotor_41} =0
generated_note_name_1668 Start point I
pre_gmotor_35 (required) 35. Does the child raise self to a standing position, using a chair or other convenient object for support?
Materials: Object of interest
1 Yes
0 No
pre_gmotor_36 (required) 36. Does the child bounce up and down at least twice by alternately bending and straightening the knees.
Question relevant when: ${pre_gmotor_35} =1
1 Yes
0 No
pre_gmotor_37 (required) 37. Does the child walk by making coordinated, alternating stepping movements?
Question relevant when: ${pre_gmotor_36} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_gmotor > gr_start_h_gmotor
Group relevant when: ( ${month_calculate_str} >=9 and ${month_calculate_str} <11) or ${pre_gmotor_35} =0 or ${pre_gmotor_36} =0 or ${pre_gmotor_37} =0
generated_note_name_1677 Start point H
Survey > Child Development Survey > determine_start_gmotor > gr_start_h_gmotor > pre_gr_gmotor_22
pre_gmotor_22 (required) 22. Does the child sit alone without support for at least 5 seconds?
Materials: Stopwatch
Time: 5 seconds
1 Yes
0 No
pre_gmotor_22a (22a) Elapsed time:
pre_gmotor_23 (required) 23. Does the child hold onto your thumbs to pull up to sit?
Question relevant when: ${pre_gmotor_22} =1
1 Yes
0 No
pre_gmotor_24 (required) 24. Does the child bring one or both feet up to hands (above the hips) and grasps afoot?
Materials: Facial tissue
Question relevant when: ${pre_gmotor_23} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_gmotor > gr_start_g_gmotor
Group relevant when: ( ${month_calculate_str} >6.5 and ${month_calculate_str} <9) or ${pre_gmotor_22} =0 or ${pre_gmotor_23} =0 or ${pre_gmotor_24} =0
generated_note_name_1689 Start point G
pre_gmotor_19 (required) 19. Does the child sit with slight support for at least 30 seconds?
Materials: Stopwatch
Time: 30 seconds
1 Yes
0 No
pre_gmotor_20 (required) 20. Does the child turn from back to both right and left sides?
Materials: Bell or rattle
Question relevant when: ${pre_gmotor_19} =1
1 Yes
0 No
pre_gmotor_21 (required) 21. Does the child support weight on both hands?
Materials: Object of interest
Question relevant when: ${pre_gmotor_20} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_gmotor > gr_start_f_gmotor
Group relevant when: ( ${month_calculate_str} >5.5 and ${month_calculate_str} <=6.5) or ${pre_gmotor_19} =0 or ${pre_gmotor_20} =0 or ${pre_gmotor_21} =0
generated_note_name_1698 Start point F
Field Question Answer
pre_gmotor_15 (required) 15. Does the child elevate head and upper trunk by pushing up on elbows or forearms?
Materials: Object of interest
1 Yes
0 No
Survey > Child Development Survey > determine_start_gmotor > gr_start_f_gmotor > pre_gr_gmotor_16
Group relevant when: ${pre_gmotor_15} =1
pre_gmotor_16 (required) 16. Does the child tense muscles in an effort to maintain sitting position?
Materials: Stopwatch
1 Yes
0 No
pre_gmotor_16a (16a) Elapsed time:
pre_gmotor_17 (required) 17. Does the child maintain head at least 90° from exam surface for at least 5 seconds? 1 Yes
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Annex E: Study Instrument
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Field Question Answer
Materials: Object of interest, and Stopwatch
Time: 5 seconds
Question relevant when: ${pre_gmotor_16} =1
0 No
Survey > Child Development Survey > determine_start_gmotor > gr_start_de_gmotor
Group relevant when: ( ${month_calculate_str} >3.5 and ${month_calculate_str} <=5.5) or ${pre_gmotor_15} =0 or ${pre_gmotor_16} =0 or ${pre_gmotor_17} =0
generated_note_name_1710 Start point D and E
Survey > Child Development Survey > determine_start_gmotor > gr_start_de_gmotor > pre_gr_gmotor_9
pre_gmotor_9 (required) 9. Does the child hold head erect and steady for at least 15 seconds without support?
Materials: Stopwatch
Time: 15 seconds
1 Yes
0 No
pre_gmotor_9a (9a) Time head held upright:
pre_gmotor_10 (required) 10. Does the child hold head in midline for at least 5 seconds?
Materials: Object of interest, and Stopwatch
Time: 5 seconds
Question relevant when: ${pre_gmotor_9} =1
1 Yes
0 No
pre_gmotor_11 (required) 11. Does the child hold head erect and steady without support while being moved?
Question relevant when: ${pre_gmotor_10} =1
1 Yes
0 No
Survey > Child Development Survey > determine_start_gmotor > gr_start_c_gmotor
Group relevant when: ( ${month_calculate_str} >2.5 and ${month_calculate_str} <=3.5) or ${pre_gmotor_9} =0 or ${pre_gmotor_10} =0 or ${pre_gmotor_11} =0
generated_note_name_1722 Start point C
pre_gmotor_5 (required) 5. Does the child turn head from one side to the other by raising his or her head off the supporting surface enough to
clear the nose?
Child must be able to turn to both sides.
Materials: Object of interest
1 Yes
0 No
pre_gmotor_6 (required) 6. Does the child make any alternating crawling movements with his or her legs?
Question relevant when: ${pre_gmotor_5} =1
1 Yes
0 No
pre_gmotor_7 (required) 7. Does the child maintain head in midline or lifts head slightly?
Question relevant when: ${pre_gmotor_6} =1
1 Yes
0 No
generated_note_name_1733 [ENUMERATOR] Please contact your supervisor. We couldn't calculate the start point. Please, reschedule the
interview with [fullname_caregiver].
Question relevant when: ${start_group_gmotor} =''
generated_note_name_1735 [ENUMERATOR] This child is performing below expectations for their age. If the child is distracted or not feeling well,
please take a break. Please also let your supervisor know that this child is having extreme difficulty.
Question relevant when: ${sum_passing_gmotor} > 2 and ${start_group_gmotor} !=''
failing_gmotor (required) Why is the child failing?
Question relevant when: ${sum_passing_gmotor} > 2
Response constrained to: string-length(.) > 3
Survey > Child Development Survey > (gross motor) Motor Scale: Gross Motor Subset
generated_note_name_1744 Gross Motor Subset
Thanks, now Im goint to start the Gross Motor Subset.
Question relevant when: ${start_group_gmotor} !=''
generated_note_name_1745 [ENUM]: Below, will appear some questions blocked, you have previously answered them to determine the starting
point.
Please, just click next.
Question relevant when: ${start_group_gmotor} !=''
generated_note_name_1747 Start point A and B
Question relevant when: ${start_group_gmotor} ='AB'
gmotor_1 (required) 1. Does the child randomly thrust legs several times?
Question relevant when: ${start_group_gmotor} ='AB'
1 Yes
0 No
gmotor_2 (required) 2. Does the child randomly thrust arms several times?
Question relevant when: ${start_group_gmotor} ='AB'
1 Yes
0 No
Survey > Child Development Survey > (gross motor) Motor Scale: Gross Motor Subset > gr_gmotor_3
Group relevant when: ${start_group_gmotor} ='AB'
gmotor_3 (required) 3. Does the child intermittently lift head free of your shoulder without support?
Materials: Stopwatch
1 Yes
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Field Question Answer
0 No
gmotor_3a (3a) Time head held upright:
Survey > Child Development Survey > (gross motor) Motor Scale: Gross Motor Subset > gr_gmotor_4
Group relevant when: ${start_group_gmotor} ='AB'
gmotor_4 (required) 4. Does the child hold head erect for at least 3 seconds without support?
Materials: Stopwatch
1 Yes
0 No
gmotor_4a (4a) Time head held upright:
generated_note_name_1758 Start point C
Question relevant when: ${start_group_gmotor} ='C'
gmotor_5 (required) 5. Does the child turn head from one side to the other by raising his or her head off the supporting surface enough to
clear the nose?
Child must be able to turn to both sides.
Materials: Object of interest
Question relevant when: ${start_group_gmotor} ='AB' or ${start_group_gmotor} ='C'
1 Yes
0 No
gmotor_6 (required) 6. Does the child make any alternating crawling movements with his or her legs?
Question relevant when: ${start_group_gmotor} ='C' or ( ${gmotor_1} + ${gmotor_2} + ${gmotor_3} + ${gmotor_4}
+ ${gmotor_5} ) >=1
1 Yes
0 No
gmotor_7 (required) 7. Does the child maintain head in midline or lifts head slightly?
Question relevant when: ${start_group_gmotor} ='C' or ( ${gmotor_2} + ${gmotor_3} + ${gmotor_4} + ${gmotor_5}
+ ${gmotor_6} ) >=1
1 Yes
0 No
gmotor_8 (required) 8. Does the child maintain head in midline or lifts head slightly?
Question relevant when: ${start_group_gmotor} ='C' or ( ${gmotor_3} + ${gmotor_4} + ${gmotor_5} + ${gmotor_6}
+ ${gmotor_7} ) >=1
1 Yes
0 No
generated_note_name_1763 Start point D and E
Question relevant when: ${start_group_gmotor} ='DE'
Survey > Child Development Survey > (gross motor) Motor Scale: Gross Motor Subset > gr_gmotor_9
Group relevant when: ${start_group_gmotor} ='C' or ${start_group_gmotor} ='DE' or ( ${gmotor_4} + ${gmotor_5} + ${gmotor_6} + ${gmotor_7} + ${gmotor_8} ) >=1
gmotor_9 (required) 9. Does the child hold head erect and steady for at least 15 seconds without support?
Materials: Stopwatch
Time: 15 seconds
Question relevant when: ${pre_gmotor_9} != null
1 Yes
0 No
gmotor_9a (9a) Time head held upright:
Question relevant when: ${pre_gmotor_9a} != null
gmotor_10 (required) 10. Does the child hold head in midline for at least 5 seconds?
Materials: Object of interest, and Stopwatch
Time: 5 seconds
Question relevant when: ${start_group_gmotor} ='DE' or ( ${gmotor_5} + ${gmotor_6} + ${gmotor_7} +
${gmotor_8} + ${gmotor_9} ) >=1
1 Yes
0 No
gmotor_11 (required) 11. Does the child hold head erect and steady without support while being moved?
Question relevant when: ${start_group_gmotor} ='DE' or ( ${gmotor_6} + ${gmotor_7} + ${gmotor_8} +
${gmotor_9} + ${gmotor_10} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (gross motor) Motor Scale: Gross Motor Subset > gr_gmotor_12
Group relevant when: ${start_group_gmotor} ='DE' or ( ${gmotor_7} + ${gmotor_8} + ${gmotor_9} + ${gmotor_10} + ${gmotor_11} ) >=1
gmotor_12 (required) 12. Does the child maintain raised head at least 45° from exam surface for at least 2 seconds.?
Materials: Object of interest
1 Yes
0 No
gmotor_12a (12a) If child holds head at 90°, record elapsed time:
gmotor_13 (required) 13. Does the child keep head balanced and in same plane as body or child overcompensates by tilting head toward
the vertical plane?
Question relevant when: ${start_group_gmotor} ='DE' or ( ${gmotor_8} + ${gmotor_9} + ${gmotor_10} +
${gmotor_11} + ${gmotor_12} ) >=1
1 Yes
0 No
gmotor_14 (required) 14. Does the child actively turn from both sides to his or her back?
Question relevant when: ( ${gmotor_9} + ${gmotor_10} + ${gmotor_11} + ${gmotor_12} + ${gmotor_13} ) >=1
1 Yes
0 No
generated_note_name_1776 Start point F
Question relevant when: ${start_group_gmotor} ='F'
gmotor_15 (required) 15. Does the child elevate head and upper trunk by pushing up on elbows or forearms?
Materials: Object of interest
Question relevant when: ${start_group_gmotor} ='F' or ( ${gmotor_10} + ${gmotor_11} + ${gmotor_12} +
${gmotor_13} + ${gmotor_14} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (gross motor) Motor Scale: Gross Motor Subset > gr_gmotor_16
Group relevant when: ${start_group_gmotor} ='F' or ( ${gmotor_11} + ${gmotor_12} + ${gmotor_13} + ${gmotor_14} + ${gmotor_15} ) >=1
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
73
Field Question Answer
gmotor_16 (required) 16. Does the child tense muscles in an effort to maintain sitting position?
Materials: Stopwatch
Question relevant when: ${pre_gmotor_16} != null
1 Yes
0 No
gmotor_16a (16a) Elapsed time:
Question relevant when: ${pre_gmotor_16a} != null
Field Question Answer
gmotor_17 (required) 17. Does the child maintain head at least 90° from exam surface for at least 5 seconds?
Materials: Object of interest, and Stopwatch
Time: 5 seconds
Question relevant when: ${start_group_gmotor} ='F' or ( ${gmotor_12} + ${gmotor_13} + ${gmotor_14} +
${gmotor_15} + ${gmotor_16} ) >=1
1 Yes
0 No
gmotor_18 (required) 18. Does the child shift weight from one arm to the other?
Materials: Object of interest
Question relevant when: ${start_group_gmotor} ='F' or ( ${gmotor_13} + ${gmotor_14} + ${gmotor_15} +
${gmotor_16} + ${gmotor_17} ) >=1
1 Yes
0 No
generated_note_name_1784 Start point G
Question relevant when: ${start_group_gmotor} ='G'
gmotor_19 (required) 19. Does the child sit with slight support for at least 30 seconds?
Materials: Stopwatch
Time: 30 seconds
Question relevant when: ${start_group_gmotor} ='F' or ${start_group_gmotor} ='G' or ( ${gmotor_14} +
${gmotor_15} + ${gmotor_16} + ${gmotor_17} + ${gmotor_18} ) >=1
1 Yes
0 No
gmotor_20 (required) 20. Does the child turn from back to both right and left sides?
Materials: Bell or rattle
Question relevant when: ${start_group_gmotor} ='G' or ( ${gmotor_15} + ${gmotor_16} + ${gmotor_17} +
${gmotor_18} + ${gmotor_19} ) >=1
1 Yes
0 No
gmotor_21 (required) 21. Does the child support weight on both hands?
Materials: Object of interest
Question relevant when: ${start_group_gmotor} ='G' or ( ${gmotor_16} + ${gmotor_17} + ${gmotor_18} +
${gmotor_19} + ${gmotor_20} ) >=1
1 Yes
0 No
generated_note_name_1788 Start point H
Question relevant when: ${start_group_gmotor} ='H'
Survey > Child Development Survey > (gross motor) Motor Scale: Gross Motor Subset > gr_gmotor_22
Group relevant when: ${start_group_gmotor} ='G' or ${start_group_gmotor} ='H' or ( ${gmotor_17} + ${gmotor_18} + ${gmotor_19} + ${gmotor_20} + ${gmotor_21} ) >=1
gmotor_22 (required) 22. Does the child sit alone without support for at least 5 seconds?
Materials: Stopwatch
Time: 5 seconds
Question relevant when: ${pre_gmotor_22} != null
1 Yes
0 No
gmotor_22a (22a) Elapsed time:
Question relevant when: ${pre_gmotor_22a} != null
gmotor_23 (required) 23. Does the child hold onto your thumbs to pull up to sit?
Question relevant when: ${start_group_gmotor} ='G' or ${start_group_gmotor} ='H' or ( ${gmotor_18} +
${gmotor_19} + ${gmotor_20} + ${gmotor_21} + ${gmotor_22} ) >=1
1 Yes
0 No
gmotor_24 (required) 24. Does the child bring one or both feet up to hands (above the hips) and grasps afoot?
Materials: Facial tissue
Question relevant when: ${start_group_gmotor} ='H' or ( ${gmotor_19} + ${gmotor_20} + ${gmotor_21} +
${gmotor_22} + ${gmotor_23} ) >=1
1 Yes
0 No
gmotor_25 (required) 25. Does the child roll from back to stomach, rolling from either side?
Materials: Bell or rattle
Question relevant when: ${start_group_gmotor} ='H' or ( ${gmotor_20} + ${gmotor_21} + ${gmotor_22} +
${gmotor_23} + ${gmotor_24} ) >=1
1 Yes
0 No
gmotor_26 (required) 26. Does the child sit alone without support for at least 30 seconds?
Materials: Stopwatch
Time: 30 seconds
Question relevant when: ${start_group_gmotor} ='H' or ( ${gmotor_21} + ${gmotor_22} + ${gmotor_23} +
${gmotor_24} + ${gmotor_25} ) >=1
1 Yes
0 No
gmotor_27 (required) 27. Does the child sit alone for at least 60 seconds while manipulating an object?
Materials: Object of interest, and Stopwatch
Time: 60 seconds
Question relevant when: ( ${gmotor_22} + ${gmotor_23} + ${gmotor_24} + ${gmotor_25} + ${gmotor_26} ) >=1
1 Yes
0 No
gmotor_28 (required) 28. Does the child rotate his or her trunk and reaches for object?
Materials: Bell or object of interest
Question relevant when: ( ${gmotor_23} + ${gmotor_24} + ${gmotor_25} + ${gmotor_26} + ${gmotor_27} ) >=1
1 Yes
0 No
gmotor_29 (required) 29. Does the child make at least two stepping movements that propel him or her forward, even if child does not fully 1 Yes
0 No
TOPS Uganda Graduation RCT Associate Award
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74
Field Question Answer
support own weight?
Question relevant when: ( ${gmotor_24} + ${gmotor_25} + ${gmotor_26} + ${gmotor_27} + ${gmotor_28} ) >=1
gmotor_30 (required) 30. Does the child use both arms to move forward on stomach approximately 1 meter (3 feet) or more?
Materials: Object of interest
Question relevant when: ( ${gmotor_25} + ${gmotor_26} + ${gmotor_27} + ${gmotor_28} + ${gmotor_29} ) >=1
1 Yes
0 No
gmotor_31 (required) 31. Does the child move from lying prone to being up on hands and knees?
Materials: Object of interest
Question relevant when: ( ${gmotor_26} + ${gmotor_27} + ${gmotor_28} + ${gmotor_29} + ${gmotor_30} ) >=1
1 Yes
0 No
gmotor_32 (required) 32. Does the child move from a seated position to hands and knees?
Materials: Object of interest
Question relevant when: ( ${gmotor_27} + ${gmotor_28} + ${gmotor_29} + ${gmotor_30} + ${gmotor_31} ) >=1
1 Yes
0 No
gmotor_33 (required) 33. Does the child support own weight for at least 2 seconds?
Question relevant when: ( ${gmotor_28} + ${gmotor_29} + ${gmotor_30} + ${gmotor_31} + ${gmotor_32} ) >=1
1 Yes
0 No
gmotor_34 (required) 34. Does the child make forward progress of at least 1.5 meters (5 feet) by crawling on hands and knees?
Materials: Object of interest
1 Yes
Field Question Answer
Question relevant when: ( ${gmotor_29} + ${gmotor_30} + ${gmotor_31} + ${gmotor_32} + ${gmotor_33} ) >=1 0 No
generated_note_name_1805 Start point I
Question relevant when: ${start_group_gmotor} ='I'
gmotor_35 (required) 35. Does the child raise self to a standing position, using a chair or other convenient object for support?
Materials: Object of interest
Question relevant when: ${start_group_gmotor} ='I' or ( ${gmotor_30} + ${gmotor_31} + ${gmotor_32} +
${gmotor_33} + ${gmotor_34} ) >=1
1 Yes
0 No
gmotor_36 (required) 36. Does the child bounce up and down at least twice by alternately bending and straightening the knees.
Question relevant when: ${start_group_gmotor} ='I' or ( ${gmotor_31} + ${gmotor_32} + ${gmotor_33} +
${gmotor_34} + ${gmotor_35} ) >=1
1 Yes
0 No
gmotor_37 (required) 37. Does the child walk by making coordinated, alternating stepping movements?
Question relevant when: ${start_group_gmotor} ='I' or ( ${gmotor_32} + ${gmotor_33} + ${gmotor_34} +
${gmotor_35} + ${gmotor_36} ) >=1
1 Yes
0 No
gmotor_38 (required) 38. Does the child walk sideways while holding onto furniture for support and balance?
Materials: Object of interest
Question relevant when: ${start_group_gmotor} ='I' or ( ${gmotor_33} + ${gmotor_34} + ${gmotor_35} +
${gmotor_36} + ${gmotor_37} ) >=1
1 Yes
0 No
generated_note_name_1811 Start point J
Question relevant when: ${start_group_gmotor} ='J'
gmotor_39 (required) 39. Does the child purposely lower from a standing to a sitting position in a controlled manner?
Question relevant when: ${start_group_gmotor} ='I' or ${start_group_gmotor} ='J' or ( ${gmotor_34} +
${gmotor_35} + ${gmotor_36} + ${gmotor_37} + ${gmotor_38} ) >=1
1 Yes
0 No
gmotor_40 (required) 40. Does the child stand alone for at least 3 seconds after you release his or her hands?
Question relevant when: ${start_group_gmotor} ='J' or ( ${gmotor_35} + ${gmotor_36} + ${gmotor_37} +
${gmotor_38} + ${gmotor_39} ) >=1
1 Yes
0 No
gmotor_41 (required) 41. Does the child come to a standing position, rolling first to a prone or quadruped position, without using any
support?
Question relevant when: ${start_group_gmotor} ='J' or ( ${gmotor_36} + ${gmotor_37} + ${gmotor_38} +
${gmotor_39} + ${gmotor_40} ) >=1
1 Yes
0 No
generated_note_name_1815 Start point K
Question relevant when: ${start_group_gmotor} ='K'
gmotor_42 (required) 42. Does the child take at least three steps without support, even if gait is stiff-legged and wobbly?
Question relevant when: ${start_group_gmotor} ='J' or ${start_group_gmotor} ='K' or ( ${gmotor_37} +
${gmotor_38} + ${gmotor_39} + ${gmotor_40} + ${gmotor_41} ) >=1
1 Yes
0 No
gmotor_43 (required) 43. Does the child take at least five steps independently, displaying coordination and balance?
Question relevant when: ${start_group_gmotor} ='J' or ${start_group_gmotor} ='K' or ( ${gmotor_38} +
${gmotor_39} + ${gmotor_40} + ${gmotor_41} + ${gmotor_42} ) >=1
1 Yes
0 No
gmotor_44 (required) 44. Does the child purposely throws ball forward?
Materials: Small ball
Question relevant when: ${start_group_gmotor} ='K' or ( ${gmotor_39} + ${gmotor_40} + ${gmotor_41} +
${gmotor_42} + ${gmotor_43} ) >=1
1 Yes
0 No
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
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Field Question Answer
generated_note_name_1819 Start point L
Question relevant when: ${start_group_gmotor} ='L'
gmotor_45 (required) 45. Does the child move from standing to squatting to standing while maintaining balance without using any support?
Materials: Object of interest
Question relevant when: ${start_group_gmotor} ='K' or ${start_group_gmotor} ='L' or ( ${gmotor_40} +
${gmotor_41} + ${gmotor_42} + ${gmotor_43} + ${gmotor_44} ) >=1
1 Yes
0 No
gmotor_46 (required) 46. Does the child roll to one side and stands without using any support?
Question relevant when: ${start_group_gmotor} ='K' or ${start_group_gmotor} ='L' or ( ${gmotor_41} +
${gmotor_42} + ${gmotor_43} + ${gmotor_44} + ${gmotor_45} ) >=1
1 Yes
0 No
gmotor_47 (required) 47. Does the child walk up at least three steps, using wall or handrail for support and place both feet on each step
before stepping up to the next?
Materials: Stairs
Question relevant when: ${start_group_gmotor} ='L' or ( ${gmotor_42} + ${gmotor_43} + ${gmotor_44} +
${gmotor_45} + ${gmotor_46} ) >=1
1 Yes
0 No
generated_note_name_1823 Start point M and N
Question relevant when: ${start_group_gmotor} ='MN'
gmotor_48 (required) 48. Does the child take at least two steps backward unassisted?
Question relevant when: ${start_group_gmotor} ='L' or ${start_group_gmotor} ='MN' or ( ${gmotor_43} +
${gmotor_44} + ${gmotor_45} + ${gmotor_46} + ${gmotor_47} ) >=1
1 Yes
0 No
gmotor_49 (required) 49. Does the child walk down at least three steps, using wall or handrail for support and child places both feet on each
step before stepping down to the next?
Materials: Stairs
Question relevant when: ${start_group_gmotor} ='L' or ${start_group_gmotor} ='MN' or ( ${gmotor_44} +
${gmotor_45} + ${gmotor_46} + ${gmotor_47} + ${gmotor_48} ) >=1
1 Yes
0 No
Field Question Answer
gmotor_50 (required) 50. Does the child run with good coordination?
Materials: Large ball
Question relevant when: ${start_group_gmotor} ='MN' or ( ${gmotor_45} + ${gmotor_46} + ${gmotor_47} +
${gmotor_48} + ${gmotor_49} ) >=1
1 Yes
0 No
generated_note_name_1827 Start point O
Question relevant when: ${start_group_gmotor} ='O'
Survey > Child Development Survey > (gross motor) Motor Scale: Gross Motor Subset > gr_gmotor_51
Group relevant when: ${start_group_gmotor} ='MN' or ${start_group_gmotor} ='O' or ( ${gmotor_46} + ${gmotor_47} + ${gmotor_48} + ${gmotor_49} + ${gmotor_50} ) >=1
gmotor_51 (required) 51. Does the child balance on right foot while you hold one of his or her hands?
Materials: Stopwatch
Question relevant when: ${pre_gmotor_51} != null
1 Yes
0 No
gmotor_51a (51a) Elapsed time with support:
Question relevant when: ${pre_gmotor_51a} != null
gmotor_51b (51b) Elapsed time without support:
Question relevant when: ${pre_gmotor_51b} != null
Survey > Child Development Survey > (gross motor) Motor Scale: Gross Motor Subset > gr_gmotor_52
Group relevant when: ${start_group_gmotor} ='MN' or ${start_group_gmotor} ='O' or ( ${gmotor_47} + ${gmotor_48} + ${gmotor_49} + ${gmotor_50} + ${gmotor_51} ) >=1
gmotor_52 (required) 52. Does the child balance on left foot while you hold one of his or her hands?
Materials: Stopwatch
Question relevant when: ${pre_gmotor_52} != null
1 Yes
0 No
gmotor_52a (52a) Elapsed time with support:
Question relevant when: ${pre_gmotor_52a} != null
gmotor_52b (52b) Elapsed time without support:
Question relevant when: ${pre_gmotor_52b} != null
gmotor_53 (required) 53. Does the child take at least two steps sideways without support?
Question relevant when: ${start_group_gmotor} ='O' or ( ${gmotor_48} + ${gmotor_49} + ${gmotor_50} +
${gmotor_51} + ${gmotor_52} ) >=1
1 Yes
0 No
generated_note_name_1839 Start point P
Question relevant when: ${start_group_gmotor} ='P'
gmotor_54 (required) 54. Does the child jump to floor?
Materials: Stairs
Question relevant when: ${start_group_gmotor} ='O' or ${start_group_gmotor} ='P' or ( ${gmotor_49} +
${gmotor_50} + ${gmotor_51} + ${gmotor_52} + ${gmotor_53} ) >=1
1 Yes
0 No
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gmotor_55 (required) 55. Does the child maintain balance while kicking ball in aforward direction at least 60 cm. (2 feet)?
Materials: Large ball
Trials: 3
Question relevant when: ${start_group_gmotor} ='O' or ${start_group_gmotor} ='P' or ( ${gmotor_50} +
${gmotor_51} + ${gmotor_52} + ${gmotor_53} + ${gmotor_54} ) >=1
1 Yes
0 No
gmotor_56 (required) 56. Does the child walk with at least one foot (i .e., left foot or right foot) on path for at least 1.5 meters (5 feet)?
Materials: Stepping path
Question relevant when: ${start_group_gmotor} ='P' or ( ${gmotor_51} + ${gmotor_52} + ${gmotor_53} +
${gmotor_54} + ${gmotor_55} ) >=1
1 Yes
0 No
generated_note_name_1843 Start point Q
Question relevant when: ${start_group_gmotor} ='Q'
gmotor_57 (required) 57. Does the child walk up three steps without using wall or handrail for support and place both feet on each step
before stepping up to the next?
Materials: Stairs
Question relevant when: ${start_group_gmotor} ='P' or ${start_group_gmotor} ='Q' or ( ${gmotor_52} +
${gmotor_53} + ${gmotor_54} + ${gmotor_55} + ${gmotor_56} ) >=1
1 Yes
0 No
gmotor_58 (required) 58. Does the child walks down three steps without using wall or handrail for support and place both feet on each step
before stepping up to the next?
Materials: Stairs
Question relevant when: ${start_group_gmotor} ='P' or ${start_group_gmotor} ='Q' or ( ${gmotor_53} +
${gmotor_54} + ${gmotor_55} + ${gmotor_56} + ${gmotor_57} ) >=1
1 Yes
0 No
Survey > Child Development Survey > (gross motor) Motor Scale: Gross Motor Subset > gr_gmotor_59
Group relevant when: ${start_group_gmotor} ='Q' or ( ${gmotor_54} + ${gmotor_55} + ${gmotor_56} + ${gmotor_57} + ${gmotor_58} ) >=1
gmotor_59 (required) 59. Does the child jumps at least 4 inches in any trial?
Materials: Stepping path
Trials: 3
Question relevant when: ${pre_gmotor_59} != null
1 Yes
0 No
gmotor_59a (59a) Trial 1 - Distance:
Question relevant when: ${pre_gmotor_59a} != null
gmotor_59b (59b) Trial 2 - Distance:
Question relevant when: ${pre_gmotor_59b} != null
gmotor_59c (59c) Trial 3 - Distance:
Question relevant when: ${pre_gmotor_59c} != null
Survey > Child Development Survey > (gross motor) Motor Scale: Gross Motor Subset > gr_gmotor_60
Group relevant when: ${start_group_gmotor} ='Q' or ( ${gmotor_55} + ${gmotor_56} + ${gmotor_57} + ${gmotor_58} + ${gmotor_59} ) >=1
Field Question Answer
gmotor_60 (required) 60. Does the child balances alone on right foot for at least 2 seconds?
Materials: Stopwatch
1 Yes
0 No
gmotor_60a (60a) Elapsed time with support:
gmotor_60b (60b) Elapsed time without support:
Survey > Child Development Survey > (gross motor) Motor Scale: Gross Motor Subset > gr_gmotor_61
Group relevant when: ${start_group_gmotor} ='Q' or ( ${gmotor_56} + ${gmotor_57} + ${gmotor_58} + ${gmotor_59} + ${gmotor_60} ) >=1
gmotor_61 (required) 61. Does the child balances alone on left foot for at least 2 second?
Materials: Stopwatch
1 Yes
0 No
gmotor_61a (61a) Elapsed time with support:
gmotor_61b (61b) Elapsed time without support:
gmotor_62 (required) 62. Does the child take at least four steps unassisted without touching heels to floor?
Materials: Stepping path
Question relevant when: ( ${gmotor_57} + ${gmotor_58} + ${gmotor_59} + ${gmotor_60} + ${gmotor_61} ) >= 1
1 Yes
0 No
gmotor_63 (required) 63. Does the child walk backward unassisted close to the path for at least 1.5 meters (5 feet)?
Materials: Stepping path
Question relevant when: ( ${gmotor_58} + ${gmotor_59} + ${gmotor_60} + ${gmotor_61} + ${gmotor_62} ) >= 1
1 Yes
0 No
Survey > Child Development Survey > (gross motor) Motor Scale: Gross Motor Subset > gr_gmotor_65
Group relevant when: ( ${gmotor_59} + ${gmotor_60} + ${gmotor_61} + ${gmotor_62} + ${gmotor_63} ) >= 1
note_gmotor_65 65. Does the child correctly imitates the positions? 1 Yes
0 No
gmotor_item_65_1 (required) Position 1 1 Yes
0 No
gmotor_item_65_2 (required) Position 2 1 Yes
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0 No
gmotor_item_65_3 (required) Position 3 1 Yes
0 No
gmotor_66 (required) 66. Does the child stop in acontrolled fashion within two steps of end of the stepping path, in at least two trials?
Materials: Stepping path
Trials: 3
Question relevant when: ( ${gmotor_60} + ${gmotor_61} + ${gmotor_62} + ${gmotor_63} + ${gmotor_65} ) >= 1
1 Yes
0 No
gmotor_68 (required) 68. Does the child hop on one foot for a distance of at least 1.5 meters (5 feet)?
Materials: Stepping path
Question relevant when: ( ${gmotor_61} + ${gmotor_62} + ${gmotor_63} + ${gmotor_65} + ${gmotor_66} ) >= 1
1 Yes
0 No
gmotor_69 (required) 69. Does the child balance alone on right foot for at least 8 seconds?
Materials: Stopwatch
Time: 8 seconds
Question relevant when: ( ${gmotor_62} + ${gmotor_63} + ${gmotor_65} + ${gmotor_66} + ${gmotor_68} ) >= 1
1 Yes
0 No
gmotor_70 (required) 70. Does the child balance alone on left foot for at least 8 seconds?
Materials: Stopwatch
Time: 8 seconds
Question relevant when: ( ${gmotor_63} + ${gmotor_65} + ${gmotor_66} + ${gmotor_68} + ${gmotor_69} ) >= 1
1 Yes
0 No
gmotor_71 (required) 71. Does the child touch heel of one foot to toe of other foot two out of three steps during one trip down stepping path?
Materials: Stepping path
Question relevant when: ( ${gmotor_65} + ${gmotor_66} + ${gmotor_68} + ${gmotor_69} + ${gmotor_70} ) >= 1
1 Yes
0 No
gmotor_72 (required) 72. Does the child jump at least 24 inches in any trial?
Materials: Stepping path
Trials: 3
Question relevant when: ( ${gmotor_66} + ${gmotor_68} + ${gmotor_69} + ${gmotor_70} + ${gmotor_71} ) >= 1
1 Yes
0 No
Survey > Child Development Survey > Social-Emotional Scale
Group relevant when: ${subsets_completed} =1
generated_note_name_1891 Module: Social-Emotional Scale
[ENUM]: This section should be answered by [fullname_caregiver].
generated_note_name_1892 This scale is designed to measure how well your child has met certain social-emotional milestones for his or her age.
Please give us the answer that best describes how often you observe the behavior in your child.
se_1 (required) 1. Does you child take a calm and enjoyable interest in most sounds? 0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_2 (required) 2. Can you easily get your child's attention without having to be very dramatic? 0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_3 (required) 3. Does you child take a calm and enjoyable interest in most sights, including colorful or bright things? 0 Can't tell
Field Question Answer
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_4 (required) 4. Can you easily get your child to look at things without them being very bright or colorful? 0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_5 (required) 5. Does you child calmly enjoy touching or being touched by different things? 0 Can't tell
1 None of the time
2 Some of the time
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3 Half of the time
4 Most of the time
5 All of the time
se_6 (required) 6. Can you easily get your child to respond to your touch without having to touch your child firmly to get his or her
attention ?
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_7 (required) 7. Does you child Like to be swung around, danced with while in your arms, or quickly lifted up in the air? 0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_8 (required) 8. Can you easily get your child's attention by approaching him or her, or moving him or her around slowly? 0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_9 (required) 9. Can you help your child to calm down? 0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_10 (required) 10. Does you child look at interesting sights, such as your face or a toy 0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_11 (required) 11. Does you child look at or turns toward interesting sounds? 0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_12 (required) 12. Does you child seem happy or pleased when he or she sees a favorite person (e.g., looks or smiles, makes
sounds, or moves arms in a way that expresses joy or delight)?
Question relevant when: ${month_calculate} >3
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
Field Question Answer
se_13 (required) 13. Does you child respond to people talking or playing with him or her by making sounds or faces (e.g., happy sounds
or a curious or annoyed look)?
Question relevant when: ${month_calculate} >3
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_14 (required) 14. Does you child reach for or points at things, or makes distinct sounds to show you what he or she wants (e.g ., 0 Can't tell
1 None of the time
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reaches out to be picked up or points at a toy)?
Question relevant when: ${month_calculate} >5
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_15 (required) 15. Does you child exchange two or more smiles, other looks, sounds, or actions (e.g., reaching, giving, or taking) with
a favorite person?
Question relevant when: ${month_calculate} >5
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_16 (required) 16. Does you child show you that he or she understands your actions or gestures by making an appropriate
gesture in return (e .g., makes a funny face back at you, looks at something you point to, stops doing something when
you shake your head and use a firm voice to say " No!", or smiles and does more of something when you nod with a
big smile and say "Yes!")?
Question relevant when: ${month_calculate} >9
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_17 (required) 17. Uses many consecutive actions in a back-and-forth way to show you what he or she wants or to have fun with you
(e.g., smiles, reaches out for a hug, and, when you hug, takes your hat, puts it on his or her head, and smiles proudly
OR takesyour hand, leadsyou to the refrigerator, tugs on the handle, and, after you open it, points to somet hing he or
she likes, such as food, a bottle of juice, or milk).
Question relevant when: ${month_calculate} >9
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_18 (required) 18. Does you child copie or imitate many of your sounds, words, or actions while playing with you
(e.g ., if you make funny faces and sounds, he or she copies them)?
Question relevant when: ${month_calculate} >14
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_19 (required) 19. Does you child search for something he or she wants by looking or getting you to look for it?
Question relevant when: ${month_calculate} >14
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_20 (required) 20. Does you child show you what he or she wants or needs by using a few actions in a row (e.g., leads you by the
hand to open a door and then touches or bangs on the door)?
Question relevant when: ${month_calculate} >14
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_21 (required) 21. Does you child use words or tries to use words when people talk with or play with him or her?
Question relevant when: ${month_calculate} >14
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_22 (required) 22. Does you child copies or imitate familiar make-believe play (e.g., feeds or hugs a doll)?
Question relevant when: ${month_calculate} >18
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
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se_23 (required) 23. Does you child tell you what he or she wants with one or a few words (e.g., "Juice," "Open," or "Kiss ")?
Question relevant when: ${month_calculate} >18
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_24 (required) 24. Does you child show you he or she understands your simple verbal wish (e.g., "Please show me your toy.")?
Question relevant when: ${month_calculate} >18
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_stop_6 Social-Emotional Scale must stop here if your child is 19-24 months old. Child's age is [month_calculate]
Question relevant when: ${month_calculate} >18 and ${month_calculate} <=24
se_25 (required) 25. Does you child play make-believe (e.g., feeds a doll, plays house, or pretends to be a TV or movie character) with
you or others?
Question relevant when: ${month_calculate} >24
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_26 (required) 26. Does you child use words or pictures to tell you what he or she is interested in (e.g., "See truck!")?
Question relevant when: ${month_calculate} >24
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_27 (required) 27. Does you child use words with one or more peers?
Question relevant when: ${month_calculate} >24
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_28 (required) 28. Does you child use words or pictures to show what he or she likes or dislikes (e .g., "Want that." or "No want.")?
Question relevant when: ${month_calculate} >24
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_stop_7 Social-Emotional Scale must stop here if your child is 25-30 months old. Child's age is [month_calculate]
Question relevant when: ${month_calculate} >24 and ${month_calculate} <=30
se_29 (required) 29. Does you child play make-believe with one or more peers?
Question relevant when: ${month_calculate} >30
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_30 (required) 30. Does you child play make-believe with you or others where the story makes sense (e.g., has the bears go visit
grandmother and then have a big lunch) ?
Question relevant when: ${month_calculate} >30
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_31 (required) 31. Does you child use phrases or sentences with you to ask a question about something he or she wants to do (e.g.,
"Mommy go out?" "What you doing outside?" or "Play?")?
Question relevant when: ${month_calculate} >30
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
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4 Most of the time
5 All of the time
se_32 (required) 32. Can explain why he or she wants something or wants to do something (e.g ., "Why do you want the juice?"
"Because I'm thirsty.")?
Question relevant when: ${month_calculate} >30
0 Can't tell
1 None of the time
Field Question Answer
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_33 (required) 33. Does you child describe his or her feelings to explain why he or she is doing something or wants something
(e.g., "Because I'm happy/sad/excited.")?
Question relevant when: ${month_calculate} >30
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_34 (required) 34. Does you child play make-believe with peers as well as adults where the story makes sense and has many parts
to it (e.g., the ch ildren go to school, do work, have lunch, and meet an elephant on the way home)?
Question relevant when: ${month_calculate} >30
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_35 (required) 35. Does you child have conversations with adults and peers that make sense, with four or more back-and-forth
exchanges about a variety of topics (e.g., feelings, foods, bedtimes, friends, or school)?
Question relevant when: ${month_calculate} >30
0 Can't tell
1 None of the time
2 Some of the time
3 Half of the time
4 Most of the time
5 All of the time
se_stop_8 Social-Emotional Scale must stop here if your child is 31-42 months old. Child's age is [month_calculate]
Question relevant when: ${month_calculate} >30
Survey > Child Development Survey > Adaptive Behavior Scale
Group relevant when: 0
generated_note_name_1945 [ENUM]: This section should be answered by [fullname_caregiver]
Question relevant when: 0
generated_note_name_1946 This section is designed to measure important behaviors a child displays at home, school, and in other settings.
The behaviors included range from those suitable for infants to those suitable for young children. Some items may
seem too difficult for infants while others may seem too easy for young children. Therefore, the child is likely to display
some but not all behaviors included in this scale.
Question relevant when: 0
Survey > Child Development Survey > Adaptive Behavior Scale > Communication
Group relevant when: 0
generated_note_name_1949 Communication
Question relevant when: 0
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_1
Group relevant when: 0
comun_1 (required) 1. Does your child look at others' faces when they are talking?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_1 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_2
Group relevant when: 0
comun_2 (required) 2. Does your child laugh when a parent or other person laughs? 0 Is not able
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Question relevant when: 0 1 Never
2 Sometimes
3 Always
comun_guess_2 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_3
Group relevant when: 0
comun_3 (required) 3. Does your child raise and lower voice to express different feelings or needs?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_3 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_4
Group relevant when: 0
comun_4 (required) 4. Does your child crie or fusse when upset?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_4 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_5
Group relevant when: 0
comun_5 (required) 5. Does your child raise voice to get attention?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_5 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_6
Group relevant when: 0
comun_6 (required) 6. Does your child say the names of other people (e.g., Mama, Daddy, or friends' names)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_6 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_7
Group relevant when: 0
comun_7 (required) 7. Does your child shake head or says "Yes" or "No" in response to a simple question (e.g ., "Do you want something
to drink?")?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_7 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_8
Group relevant when: 0
comun_8 (required) 8. Does your child point to common items in a room when asked (e.g., "door/radio")?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_8 Your rating is based on a guess? 1 Yes
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Question relevant when: 0 0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_9
Group relevant when: 0
comun_9 (required) 9. Does your child listen closely for at least one minute when people talk?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_9 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_10
Group relevant when: 0
comun_10 (required) 10. Does your child repeat words others say (e.g., says "baby" when an adult says "baby")?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_10 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_11
Group relevant when: 0
comun_11 (required) 11. Does your child say the name of an object clearly enough so that others recognize it (e.g., ball, dog, or cup)?
Question relevant when: 0
0 Is not able
1 Never
Field Question Answer
2 Sometimes
3 Always
comun_guess_11 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_12
Group relevant when: 0
comun_12 (required) 12. Does your child follow simple commands (e.g., "No." or "Come here.")?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_12 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_13
Group relevant when: 0
comun_13 (required) 13. Does your child follow simple directions that include over or under (e.g., "put your hands over your head .")?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_13 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_14
Group relevant when: 0
comun_14 (required) 14. Does your child sing all or part of the words to songs?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_14 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_15
Group relevant when: 0
comun_15 (required) 15. Does your child make plurals of words by adding an -s (e.g., shoes, socks, or dogs)? 0 Is not able
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
84
Field Question Answer
Question relevant when: 0 1 Never
2 Sometimes
3 Always
comun_guess_15 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_16
Group relevant when: 0
comun_16 (required) 16. Does your child name 20 or more familiar objects?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_16 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_17
Group relevant when: 0
comun_17 (required) 17. Does your child use sentences with a noun and a verb?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_17 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_18
Group relevant when: 0
comun_18 (required) 18. Does your child speak in sentences of six or more words?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_18 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_19
Group relevant when: 0
comun_19 (required) 19. Does your child tell parent, friends, or others about his or her favorite activities?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_19 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_20
Group relevant when: 0
comun_20 (required) 20. Does your child ask questions (e.g., "Will you play with me?")?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_20 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_21
Group relevant when: 0
comun_21 (required) 21. Does your child use past tense to talk about prior events (e.g., "I stayed inside.")?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_21 Your rating is based on a guess? 1 Yes
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
85
Field Question Answer
Question relevant when: 0 0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_22
Group relevant when: 0
comun_22 (required) 22. Does your child discuss a topic for more than 3 minutes?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_22 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_23
Group relevant when: 0
comun_23 (required) 23. Does your child end conversations appropriately?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_23 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Communication > comgroup_24
Group relevant when: 0
comun_24 (required) 24. Does your child refrain from interrupting others when they are talking?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comun_guess_24 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use
Group relevant when: 0
generated_note_name_2050 Community Use
Question relevant when: 0
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_1
Group relevant when: 0
comuse_1 (required) 1. Does you child cecognize own home in his or her immediate neighborhood?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_1 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_2
Group relevant when: 0
comuse_2 (required) 2. Does your child walk on side of the road rather than street/middle of the road?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_2 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_3
Group relevant when: 0
comuse_3 (required) 3. Does your chil inform parents when someone comes to the door?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_3 Your rating is based on a guess? 1 Yes
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
86
Field Question Answer
Question relevant when: 0 0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_4
Group relevant when: 0
comuse_4 (required) 4. Does your child show respect for public property (e.g., throws trash in cans, does not damage property)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_4 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_5
Group relevant when: 0
comuse_5 (required) 5. Does your child knock on a door before entering another person's home?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_5 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_6
Group relevant when: 0
comuse_6 (required) 6. Does your child refrain from talking loudly in a public place (e.g., in church)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_6 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_7
Group relevant when: 0
comuse_7 (required) 7. Does your child remains seated during a religious service?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_7 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_8
Group relevant when: 0
comuse_8 (required) 8. Does your child refrain from touching items in a store?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_8 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_9
Group relevant when: 0
comuse_9 (required) 9. Does your child ask to go to a park or other favorite community place?
Question relevant when: 0
0 Is not able
1 Never
Field Question Answer
2 Sometimes
3 Always
comuse_guess_9 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_10
Group relevant when: 0
comuse_10 (required) 10. Does your child ask to get a snack from store? 0 Is not able
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
87
Field Question Answer
Question relevant when: 0 1 Never
2 Sometimes
3 Always
comuse_guess_10 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_11
Group relevant when: 0
comuse_11 (required) 11. Does your child say what items are purchased at various stores (e.g., food at grocery stores)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_11 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_12
Group relevant when: 0
comuse_12 (required) 12. Does your child recognize and names buildings (e.g., hospital, gas station, or fire department)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_12 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_13
Group relevant when: 0
comuse_13 (required) 13. Does your child recognize the need to pay for an item before leaving a store?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_13 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_14
Group relevant when: 0
comuse_14 (required) 14. Does your child identify neighborhood locations where his or her family obtains needed items (e.g., where to buy
food)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_14 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_15
Group relevant when: 0
comuse_15 (required) 15. Does your child describe the duties of workers (e.g., says that firefighters put out fires and doctors help the sick)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_15 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_16
Group relevant when: 0
comuse_16 (required) 16. Does your child look both ways before crossing a street or parking lot?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_16 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
88
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_18
Group relevant when: 0
comuse_18 (required) 18. Does your child find location to go potty at the shop?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_18 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_19
Group relevant when: 0
comuse_19 (required) 19. Does your child ask for something from the vendor for the market?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_19 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_20
Group relevant when: 0
comuse_20 (required) 20. Does your child make a small purchase at a food store (the child complete the transaccion with the vendor
market)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_20 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_21
Group relevant when: 0
comuse_21 (required) 21. Does your child walk alone to friends' houses in the village?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_21 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Community Use > comusegroup_22
Group relevant when: 0
comuse_22 (required) 22. Does your child carry enough money to make small purchases (e.g., a soft drink)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
comuse_guess_22 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics
Group relevant when: 0
generated_note_name_2139 Functional Pre-Academics
Question relevant when: 0
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_1
Group relevant when: 0
functacad_1 (required) 1. Does your child point to pictures in books when asked (e.g., points to a horse or cow)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_1 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_2
Group relevant when: 0
functacad_2 (required) 2. Does your child hold crayon or pencil with point down when using paper? 0 Is not able
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
89
Field Question Answer
Question relevant when: 0 1 Never
2 Sometimes
3 Always
functacad_guess_2 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_3
Group relevant when: 0
functacad_3 (required) 3. Does your child state his or her age in years when asked?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_3 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_4
Group relevant when: 0
functacad_4 (required) 4. Does your child count three or more objects?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_4 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_5
Group relevant when: 0
functacad_5 (required) 5. Does your child attempt to imitate simple drawings (e.g., copying a line or circle)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_5 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_6
Group relevant when: 0
functacad_6 (required) 6. Does your child sing the alphabet song?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_6 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_7
Group relevant when: 0
functacad_7 (required) 7. Does your child name six or more colors including red, blue, and yellow?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_7 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_8
Group relevant when: 0
functacad_8 (required) 8. Does your child recite nursery rhymes from memory?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_8 Your rating is based on a guess? 1 Yes
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
90
Field Question Answer
Question relevant when: 0 0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_9
Group relevant when: 0
functacad_9 (required) 9. Does your child identify at least two numbers from a group of numbers?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_9 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_10
Group relevant when: 0
functacad_10 (required) 10. Does your child name four or more shapes (e.g., circle, square, rectangle, and triangle)?
Question relevant when: 0
0 Is not able
1 Never
Field Question Answer
2 Sometimes
3 Always
functacad_guess_10 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_11
Group relevant when: 0
functacad_11 (required) 11. Does your child read own name when printed?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_11 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_12
Group relevant when: 0
functacad_12 (required) 12. Does your child count 10 or more objects without using fingers?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_12 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_13
Group relevant when: 0
functacad_13 (required) 13. Does your child draw a recognizable face including two eyes, a nose, mouth, and hair?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_13 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_14
Group relevant when: 0
functacad_14 (required) 14. Does your child name at least two letters when shown own name?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_14 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_15
Group relevant when: 0
functacad_15 (required) 15. Does your child name most letters when shown the alphabet? 0 Is not able
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
91
Field Question Answer
Question relevant when: 0 1 Never
2 Sometimes
3 Always
functacad_guess_15 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_16
Group relevant when: 0
functacad_16 (required) 16. Does your child counts from 1 to 20?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_16 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_17
Group relevant when: 0
functacad_17 (required) 17. Does your child print at least two letters in own name?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_17 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_18
Group relevant when: 0
functacad_18 (required) 18. Does your child read and obeys common signs (eg., Do Not Enter, Exit, or Stop)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_18 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_19
Group relevant when: 0
functacad_19 (required) 19. Does your child state the days of the week in order?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_19 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_20
Group relevant when: 0
functacad_20 (required) 20. Does your child write numbers 1 to 10?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_20 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_21
Group relevant when: 0
functacad_21 (required) 21. Does your child tell what day comes before another (eg. "Wednesdays comes before Thursday"?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_21 Your rating is based on a guess? 1 Yes
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
92
Field Question Answer
Question relevant when: 0 0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Functional Pre-Academics > fagroup_22
Group relevant when: 0
functacad_22 (required) 22. Does your child write his or her first and last names?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
functacad_guess_22 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living
Group relevant when: 0
generated_note_name_2232 Home Living
Question relevant when: 0
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_1
Group relevant when: 0
homeliv_1 (required) 1. Does your child remove biscuits or other food from a box or bag?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_1 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_3
Group relevant when: 0
homeliv_3 (required) 3. Does your child show concern when he or she spills something (e.g., says "Oh no!" or tells an adult)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_3 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_4
Group relevant when: 0
homeliv_4 (required) 4. Does your child point to the place where his or her clothes are stored?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_4 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_6
Group relevant when: 0
homeliv_6 (required) 6. Does your child assist other people with putting away toys, games, and other items?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_6 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_7
Group relevant when: 0
homeliv_7 (required) 7. Does your child pick up and throws away trash or paper at home?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_7 Your rating is based on a guess? 1 Yes
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
93
Field Question Answer
Question relevant when: 0 0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_8
Group relevant when: 0
homeliv_8 (required) 8. Does your child do simple errand when asked (e.g., runs to get a towel for a spill)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_8 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_9
Group relevant when: 0
homeliv_9 (required) 9. Does your child attempt to wipe up spills, even if an adult must help?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_9 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_10
Group relevant when: 0
homeliv_10 (required) 10. Does your child refrain from kicking or hitting furniture?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_10 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_11
Group relevant when: 0
homeliv_11 (required) 11. Does your child get own snacks from cabinet or pantry?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_11 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_12
Group relevant when: 0
homeliv_12 (required) 12. Does your child offer to help a parent or other adult with tasks?
Question relevant when: 0
0 Is not able
1 Never
Field Question Answer
2 Sometimes
3 Always
homeliv_guess_12 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_13
Group relevant when: 0
homeliv_13 (required) 13. Does your child refrain from throwing food or paper on the floor?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_13 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_14
Group relevant when: 0
homeliv_14 (required) 0 Is not able
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
94
Field Question Answer
14. Does your child assist adults with preparing simple snacks or meals (e.g ., hands slices of bread to adult for
making sandwiches)?
Question relevant when: 0
1 Never
2 Sometimes
3 Always
homeliv_guess_14 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_15
Group relevant when: 0
homeliv_15 (required) 15. Does your child place dirty clothes in the proper place (e.g., a hamper or clothesbasket)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_15 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_16
Group relevant when: 0
homeliv_16 (required) 16. Does your child wipe up spills at home?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_16 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_17
Group relevant when: 0
homeliv_17 (required) 17. Does your child put own dirty glass or plate in pan for dishwasher?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_17 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_18
Group relevant when: 0
homeliv_18 (required) 18. Does your child take own clothes when getting dressed?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_18 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_19
Group relevant when: 0
homeliv_19 (required) 19. Does your child keep dirty shoes and feet off furniture?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_19 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_20
Group relevant when: 0
homeliv_20 (required) 20. Does your child put things in their proper places when finished using them?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_20 Your rating is based on a guess? 1 Yes
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
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Field Question Answer
Question relevant when: 0 0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_21
Group relevant when: 0
homeliv_21 (required) 21. Does your child keep toys, games, and other belongings neat and clean?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_21 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_22
Group relevant when: 0
homeliv_22 (required) 22. Does your child wipe wet or dirty shoes before entering a house or a building?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_22 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_23
Group relevant when: 0
homeliv_23 (required) 23. Does your child dispose of own leftover food?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_23 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_24
Group relevant when: 0
homeliv_24 (required) 24. Does your child make his or her own bed?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_24 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Home Living > homelivgroup_25
Group relevant when: 0
homeliv_25 (required) 25. Does your child fold clean clothes?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
homeliv_guess_25 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety
Group relevant when: 0
generated_note_name_2329 Health and Safety
Question relevant when: 0
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_1
Group relevant when: 0
health_1 (required) 1. Does your child cry or whimper when he or she does not feel well or is injured?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_1 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
96
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_2
Group relevant when: 0
health_2 (required) 2. Does your child swallow liquid medicines if needed for illness?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_2 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_3
Group relevant when: 0
health_3 (required) 3. Does your child avoid bumping into walls or objects when cscoreling or walking?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_3 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_4
Group relevant when: 0
health_4 (required) 4. Does your child show, points to, or tells another person about a cut, bruise, or other minor injury?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_4 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_5
Group relevant when: 0
health_5 (required) 5. Does your child follow an adult's directions to "Stop" when in danger (e.g., near a hot stove)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_5 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_6
Group relevant when: 0
health_6 (required) 6. Does your child point to the body part that hurts when sick or injured?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_6 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_7
Group relevant when: 0
health_7 (required) 7. Does your child avoid getting too near a fire or hot stove?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_7 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_8
Group relevant when: 0
health_8 (required) 8. Does your child allow temperature to be taken without fussing?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_8 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
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Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_9
Group relevant when: 0
health_9 (required) 9. Does your child remain fairly still when an adult treats a cut or scrape?
Question relevant when: 0
0 Is not able
1 Never
Field Question Answer
2 Sometimes
3 Always
health_guess_9 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_10
Group relevant when: 0
health_10 (required) 10. Does your child test hot foods before eating them?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_10 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_11
Group relevant when: 0
health_11 (required) 11. Does your child avoid touching or playing with dangerous items (e.g., insect spray or sharp knives)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_11 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_12
Group relevant when: 0
health_12 (required) 12. Does your child tell an adult if he or she has a stomach ache or other illness?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_12 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_13
Group relevant when: 0
health_13 (required) 13. Does your child refrain from putting toys in mouth?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_13 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_14
Group relevant when: 0
health_14 (required) 14. Does your child avoid crawling or climbing on high or dangerous places?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_14 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_15
Group relevant when: 0
health_15 (required) 15. Does your child stay within sight of parents or other familiar adults in a public place without wandering off?
Question relevant when: 0
0 Is not able
1 Never
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
98
Field Question Answer
2 Sometimes
3 Always
health_guess_15 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_16
Group relevant when: 0
health_16 (required) 16. Does your child put on a coat or sweater when cold?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_16 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_17
Group relevant when: 0
health_17 (required) 17. Does your child carry breakable objects safely and carefully?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_17 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_18
Group relevant when: 0
health_18 (required) 18. Does your child ask an adult before going near something that could be dangerous (e.g., animals)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_18 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_20
Group relevant when: 0
health_20 (required) 20. Does your child carry scissors safely?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_20 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_22
Group relevant when: 0
health_22 (required) 22. Does your child carry hot containers safely and carefully?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_22 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_23
Group relevant when: 0
health_23 (required) 23. Does your child have a safe behavior around cooking fire?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_23 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
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Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Health and Safety > hsgroup_24
Group relevant when: 0
health_24 (required) 24. Does your child care for his or her minor injuries (e.g., paper cuts, knee scrapes, or nosebleeds)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
health_guess_24 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure
Group relevant when: 0
generated_note_name_2422 Leisure
Question relevant when: 0
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_1
Group relevant when: 0
leisure_1 (required) 1. Does your child play with a single toy or game for at least one minute?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_1 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_2
Group relevant when: 0
leisure_2 (required) 2. Does your child play alone with toys, games, or other fun activities?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_2 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_3
Group relevant when: 0
leisure_3 (required) 3. Does your child look at pictures in books with an adult?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_3 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_4
Group relevant when: 0
leisure_4 (required) 4. Does your child watch for a few minutes as people play with toys or games?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_4 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_5
Group relevant when: 0
leisure_5 (required) 5. Does your child play simple games like "peek-a-boo" or rolls a ball to others?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_5 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
100
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_6
Group relevant when: 0
leisure_6 (required) 6. Does your child choose a game or toy during playtime?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_6 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_7
Group relevant when: 0
leisure_7 (required) 7. Does your child play with a single toy or game for more than five minutes?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_7 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_8
Group relevant when: 0
leisure_8 (required) 8. Does your child climbs things out side at house (eg. tree) with an adult?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_8 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_9
Group relevant when: 0
leisure_9 (required) 9. Does your child play with toys, games, or other fun items with other people?
Question relevant when: 0
0 Is not able
1 Never
Field Question Answer
2 Sometimes
3 Always
leisure_guess_9 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_10
Group relevant when: 0
leisure_10 (required) 10. Does your child play with other children when asked?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_10 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_11
Group relevant when: 0
leisure_11 (required) 11. Does your child climbs things out side at house (eg. tree) on their own?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_11 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_12
Group relevant when: 0
leisure_12 (required) 12. Does your child ask to hear a story?
Question relevant when: 0
0 Is not able
1 Never
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
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Field Question Answer
2 Sometimes
3 Always
leisure_guess_12 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_13
Group relevant when: 0
leisure_13 (required) 13. Does your child attend fun activities at another's home?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_13 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_14
Group relevant when: 0
leisure_14 (required) 14. Does your child play simple games with playmates without adult supervision?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_14 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_15
Group relevant when: 0
leisure_15 (required) 15. Does your child invite others to join him or her in playing games and other fun activities?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_15 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_16
Group relevant when: 0
leisure_16 (required) 16. Does your child participate in a specific fun activity on a routine basis (e.g., listening to a certain type of music,
dancing)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_16 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_17
Group relevant when: 0
leisure_17 (required) 17. Does your child wait for his or her own turn in games and other fun activities?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_17 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_18
Group relevant when: 0
leisure_18 (required) 18. Does your child save things of interest (e.g., rocks, feathers, or pictures)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_18 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
102
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_19
Group relevant when: 0
leisure_19 (required) 19. Does your child invite others home for a fun activity?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_19 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_20
Group relevant when: 0
leisure_20 (required) 20. Does your child play simple play game like hide-and-seek?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_20 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Leisure > leisuregroup_21
Group relevant when: 0
leisure_21 (required) 21. Does your child follow the rules in games?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
leisure_guess_21 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care
Group relevant when: 0
generated_note_name_2511 Self-Care
Question relevant when: 0
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_1
Group relevant when: 0
selfcare_1 (required) 1. Does your child swallow liquids with no difficulty?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_1 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_2
Group relevant when: 0
selfcare_2 (required) 2. Does your child nurse, drink, or eat willingly, with little encouragement?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_2 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_3
Group relevant when: 0
selfcare_3 (required) 3. Does your child swallow soft, strained, or mashed food (e.g., baby food or applesauce)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_3 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
The Impact of a Graduation Program on Child Development in Refugee and Host Communities in Uganda
Annex E: Study Instrument
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Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_4
Group relevant when: 0
selfcare_4 (required) 4. Does your child sleep through most of the night, waking no more than one or two times?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_4 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_5
Group relevant when: 0
selfcare_5 (required) 5. Does your child open mouth when offered food on a spoon?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_5 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_6
Group relevant when: 0
selfcare_6 (required) 6. Does your child feed himself or herself crackers, cookies, dry cereal, or other finger foods?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_6 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_7
Group relevant when: 0
selfcare_7 (required) 7. Does your child drink from a cup or glass, even if another person must hold it?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_7 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_8
Group relevant when: 0
selfcare_8 (required) 8. Does your child hold and drinks from a sipping cup?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_8 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_9
Group relevant when: 0
selfcare_9 (required) 9. Does your child lif arms as needed when another person is dressing or undressing him or her?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_9 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_10
Group relevant when: 0
selfcare_10 (required) 10. Does your child point to or asks for food when hungry?
Question relevant when: 0
0 Is not able
1 Never
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
104
Field Question Answer
2 Sometimes
3 Always
selfcare_guess_10 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_11
Group relevant when: 0
selfcare_11 (required) 11. Does your child take shoes off?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_11 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_12
Group relevant when: 0
selfcare_12 (required) 12. Does your child sleep through the entire night without waking?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_12 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_13
Group relevant when: 0
selfcare_13 (required) 13. Does your child wash hands with soap?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_13 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_14
Group relevant when: 0
selfcare_14 (required) 14. Does your child sit on the potty without being held?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_14 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_15
Group relevant when: 0
selfcare_15 (required) 15. Does your child wipe own face when given a cloth by an adult?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_15 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_16
Group relevant when: 0
selfcare_16 (required) 16. Does your child go to bed with few or no complaints?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_16 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_17
Group relevant when: 0
selfcare_17 (required) 17. Does your child tell parent or other adult when he or she needs to go to the potty?
Question relevant when: 0
0 Is not able
1 Never
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Field Question Answer
2 Sometimes
3 Always
selfcare_guess_17 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_19
Group relevant when: 0
selfcare_19 (required) 19. Does your child go to the potty at home without assitance?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_19 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_20
Group relevant when: 0
selfcare_20 (required) 20. Does your child dress himself or herself?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_20 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_21
Group relevant when: 0
selfcare_21 (required) 21. Does your child button his or her own clothing?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_21 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_22
Group relevant when: 0
selfcare_22 (required) 22. Does your child take a bath or shower without help?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_22 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_23
Group relevant when: 0
selfcare_23 (required) 23. Does your child wash his or her own hair?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_23 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Care > selfcaregroup_24
Group relevant when: 0
selfcare_24 (required) 24. Does your child cut meats or other foods into bite-size pieces?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfcare_guess_24 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
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Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction
Group relevant when: 0
generated_note_name_2608 Self-Direction
Question relevant when: 0
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_1
Group relevant when: 0
selfdirec_1 (required) 1. Does your child show interest in a toy or other object by looking at it fo r a few seconds?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_1 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_2
Group relevant when: 0
selfdirec_2 (required) 2. Does your child stop fussing or crying when picked up or spoken to?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_2 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_3
Group relevant when: 0
selfdirec_3 (required) 3. Does your child entertain self in crib or bed for at least one minute after waking?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_3 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_4
Group relevant when: 0
selfdirec_4 (required) 4. Does your child sit quietly for at least one minute without demanding attention?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_4 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_5
Group relevant when: 0
selfdirec_5 (required) 5. Does your child find something to do for at least five minutes without demanding attention?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_5 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_6
Group relevant when: 0
selfdirec_6 (required) 6. Does your child show interest in a toy or other object by pointing to it?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_6 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
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Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_7
Group relevant when: 0
selfdirec_7 (required) 7. Does your child move a few feet away from a parent in a new situation as long as the parent is in sight (e.g., when
visiting in an unfamiliar house)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_7 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_8
Group relevant when: 0
selfdirec_8 (required) 8. Does your child choose the food or snack he or she wishes to eat when given a choice?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_8 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_9
Group relevant when: 0
selfdirec_9 (required) 9. Does your child explore an unfamiliar room or other new situation, even if parent must encourage it (e.g., a waiting
room)?
0 Is not able
1 Never
Field Question Answer
Question relevant when: 0 2 Sometimes
3 Always
selfdirec_guess_9 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_10
Group relevant when: 0
selfdirec_10 (required) 10. Does your child obey an adult's request to "Quiet down" or "Behave."?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_10 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_11
Group relevant when: 0
selfdirec_11 (required) 11. Does your child try to do most things without an adult's help (e.g., dressing or feeding self)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_11 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_12
Group relevant when: 0
selfdirec_12 (required) 12. Does your child follow simple household rules such as no running in the house?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_12 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_13
Group relevant when: 0
selfdirec_13 (required) 13. Does your child resist pushing or hitting another child when angry or upset?
Question relevant when: 0
0 Is not able
1 Never
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Annex E: Study Instrument
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Field Question Answer
2 Sometimes
3 Always
selfdirec_guess_13 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_14
Group relevant when: 0
selfdirec_14 (required) 14. Does your child start an activity almost immediately when told to do so (e.g., clean up, fetch water)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_14 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_15
Group relevant when: 0
selfdirec_15 (required) 15. Does your child keep working on hard tasks without becoming discouraged or quitting?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_15 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_16
Group relevant when: 0
selfdirec_16 (required) 16. Does your child ask permission from adult when needed (e.g., "May I play outside?")?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_16 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_17
Group relevant when: 0
selfdirec_17 (required) 17. Does your child work independently and asks for help only when necessary?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_17 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_18
Group relevant when: 0
selfdirec_18 (required) 18. Does your child control temper when a parent or other adult takes a toy or object away?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_18 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_19
Group relevant when: 0
selfdirec_19 (required) 19. Does your child work on one home or school activity for at least 15 minutes?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_19 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
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Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_20
Group relevant when: 0
selfdirec_20 (required) 20. Does your child stop a fun activity, without complaints, when told that time is up?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_20 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_21
Group relevant when: 0
selfdirec_21 (required) 21. Does your child control temper when disagreeing with friends?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_21 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_22
Group relevant when: 0
selfdirec_22 (required) 22. Does your child follow a routine without being reminded (e.g., brushing teeth before bedtime or regularly feeding a
pet)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_22 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_23
Group relevant when: 0
selfdirec_23 (required) 23. Does your child ask permission before playing with another child's toy or game?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_23 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_24
Group relevant when: 0
selfdirec_24 (required) 24. Does your child choose own clothes almost every day?
Question relevant when: 0
0 Is not able
1 Never
Field Question Answer
2 Sometimes
3 Always
selfdirec_guess_24 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Self-Direction > selfdirecgroup_25
Group relevant when: 0
selfdirec_25 (required) 25. Does your child discuss ways to solve conflicts with others (e.g., "You can have this now if Ican have it later.")?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
selfdirec_guess_25 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social
Group relevant when: 0
generated_note_name_2713 Social
Question relevant when: 0
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Annex E: Study Instrument
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Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_1
Group relevant when: 0
social_1 (required) 1. Does your child smile when he or she sees parent?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_1 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_2
Group relevant when: 0
social_2 (required) 2. Does your child squeal or laughs when happy or delighted?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_2 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_3
Group relevant when: 0
social_3 (required) 3. Does your child relaxe body when held (e.g., snuggles)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_3 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_4
Group relevant when: 0
social_4 (required) 4. Does your child lif arms to express a desire to be picked up?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_4 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_5
Group relevant when: 0
social_5 (required) 5. Does your child show a sense of humor(e.g., laughs when someone acts silly)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_5 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_6
Group relevant when: 0
social_6 (required) 6. Does your child display a special closeness or relationship to parent (e.g., acts happy when parent returns)?
Question relevant when: 0
0 Is not able
1 Never
Field Question Answer
2 Sometimes
3 Always
social_guess_6 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_7
Group relevant when: 0
social_7 (required) 7. Does your child respond differently to familiar and unfamiliar persons (e.g., is less warm to an unfamiliar person)?
Question relevant when: 0
0 Is not able
1 Never
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2 Sometimes
3 Always
social_guess_7 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_8
Group relevant when: 0
social_8 (required) 8. Does your child hug and kisses parents or others?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_8 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_9
Group relevant when: 0
social_9 (required) 9. Does your child run to greet special family members and friends?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_9 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_10
Group relevant when: 0
social_10 (required) 10. Does your child imitate actions of adults (e.g., pretends to clean house or drive a car)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_10 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_11
Group relevant when: 0
social_11 (required) 11. Does your child share toys willingly with others?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_11 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_12
Group relevant when: 0
social_12 (required) 12. Does your child greet other children (e.g., says "Hi")?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_12 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_13
Group relevant when: 0
social_13 (required) 13. Does your child say "Thank you" when given a gift?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_13 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
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Annex E: Study Instrument
112
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_14
Group relevant when: 0
social_14 (required) 14. Does your child show sympathy for others when they are sad or upset?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_14 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_15
Group relevant when: 0
social_15 (required) 15. Does your child seek friendship with others in his or her age group?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_15 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_16
Group relevant when: 0
social_16 (required) 16. Does your child respond appropriately when introduced to others (e.g., says "Hello")?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_16 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_17
Group relevant when: 0
social_17 (required) 17. Does your child move out of another person's way without being asked?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_17 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_18
Group relevant when: 0
social_18 (required) 18. Does your child offer assistance to others (e.g., offers to carry packages or put away food)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_18 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_19
Group relevant when: 0
social_19 (required) 19. Does your child say when he or she feels happy, sad, scared, or angry?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_19 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_20
Group relevant when: 0
social_20 (required) 20. Does your child state when others seem happy, sad, scared, or angry?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_20 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
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Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_21
Group relevant when: 0
social_21 (required) 21. Does your child apologize if he or she hurts the feelings of others?
Question relevant when: 0
0 Is not able
1 Never
Field Question Answer
2 Sometimes
3 Always
social_guess_21 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_22
Group relevant when: 0
social_22 (required) 22. Does your child place reasonable demands on friends (e.g., does not become upset when a friend plays with
another friend)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_22 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_23
Group relevant when: 0
social_23 (required) 23. Does your child refrain from saying something that might embarrass or hurt others?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_23 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Social > socialgroup_24
Group relevant when: 0
social_24 (required) 24. Does your child, personally make or buys gifts for family members on major holiday?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
social_guess_24 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor
Group relevant when: 0
generated_note_name_2814 Motor
Question relevant when: 0
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_1
Group relevant when: 0
motor_1 (required) 1. Does your child follow a moving object by turning head?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess1 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_2
Group relevant when: 0
motor_2 (required) 2. Does your child lift head to look around?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess2 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
TOPS Uganda Graduation RCT Associate Award
Annex E: Study Instrument
114
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_3
Group relevant when: 0
motor_3 (required) 3. Does your child roll from stomach to side?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess3 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_4
Group relevant when: 0
motor_4 (required) 4. Does your child shake rattle or other toys?
Question relevant when: 0
0 Is not able
1 Never
Field Question Answer
2 Sometimes
3 Always
motor_guess4 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_5
Group relevant when: 0
motor_5 (required) 5. Does your child reache for objects such as a bottle or toy?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess5 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_6
Group relevant when: 0
motor_6 (required) 6. Does your child move to a sitting position, even if balance is unsteady?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess6 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_7
Group relevant when: 0
motor_7 (required) 7. Does your child sit balanced for 30 seconds or more without support?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess7 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_8
Group relevant when: 0
motor_8 (required) 8. Does your child pull self to a standing position (e.g., in a crib)?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess8 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_9
Group relevant when: 0
motor_9 (required) 9. Does your child pick up small flat objects from a table (e.g., coins or buttons)?
Question relevant when: 0
0 Is not able
1 Never
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2 Sometimes
3 Always
motor_guess9 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_10
Group relevant when: 0
motor_10 (required) 10. Does your child stand up from a sitting position?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess10 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_11
Group relevant when: 0
motor_11 (required) 11. Does your child crawl for about 3 meters (10 feet) without falling over?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess11 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_12
Group relevant when: 0
motor_12 (required) 12. Does your child roll ball to others?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess12 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_13
Group relevant when: 0
motor_13 (required) 13. Does your child walks without help?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess13 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_14
Group relevant when: 0
motor_14 (required) 14. Does your child stand on tiptoe to reach objects?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess14 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_15
Group relevant when: 0
motor_15 (required) 15. Does your child throw small ball overhanded?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess15 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
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Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_16
Group relevant when: 0
motor_16 (required) 16. Does your child run for several yards, even if the step are unsteady?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess16 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_17
Group relevant when: 0
motor_17 (required) 17. Does your child kick ball without falling?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess17 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_18
Group relevant when: 0
motor_18 (required) 18. Does your child run withouct falling?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess18 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_19
Group relevant when: 0
motor_19 (required) 19. Does your child walk up and get up on bench/seat/chair with no help from others?
Question relevant when: 0
0 Is not able
1 Never
Field Question Answer
2 Sometimes
3 Always
motor_guess19 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_20
Group relevant when: 0
motor_20 (required) 20. Does your child blow out candles?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess20 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_21
Group relevant when: 0
motor_21 (required) 21. Does your child bounce ball for several seconds?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess21 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_22
Group relevant when: 0
motor_22 (required) 22. Does your child catch ball tossed from 5 to 10 feet away?
Question relevant when: 0
0 Is not able
1 Never
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Field Question Answer
2 Sometimes
3 Always
motor_guess22 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_23
Group relevant when: 0
motor_23 (required) 23. Does your child draw straight lines across a piece of paper?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess23 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_24
Group relevant when: 0
motor_24 (required) 24. Does your child use scissors to cut paper without assistance, even if must be supervised?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess24 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_25
Group relevant when: 0
motor_25 (required) 25. Does your child color within the lines of a drawing or in a coloring book?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess25 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_26
Group relevant when: 0
motor_26 (required) 26. Does your child use scissors to cut along a straight line?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess26 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Field Question Answer
Survey > Child Development Survey > Adaptive Behavior Scale > Motor > motorgroup_27
Group relevant when: 0
motor_27 (required) 27. Does your child use scissors to cut shapes with curved lines?
Question relevant when: 0
0 Is not able
1 Never
2 Sometimes
3 Always
motor_guess27 Your rating is based on a guess?
Question relevant when: 0
1 Yes
0 No
Survey > Child Development Survey > Module: CREDI
Group relevant when: ${subsets_completed} =1
generated_note_name_2935 Module: CREDI
[ENUM]: The following questions should be answered by [fullname_caregiver]
LF39 (required) 39. Can the child sit or play on his/her own for at least 20 minutes?
Question relevant when: ( ${month_calculate} > 23 and ${month_calculate} <= 29)
1 Yes
0 No
0.1 Don't Know/No response
LF40 (required) 1 Yes
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Field Question Answer
40. Can the child walk several steps on his/her own, without holding on or receiving support?
Question relevant when: ( ${month_calculate} > 23 and ${month_calculate} <= 29)
0 No
0.1 Don't Know/No response
LF41 (required)
41. Can the child bend down to the ground and stand up again without falling and without holding onto a person or
object?
Question relevant when: ( ${month_calculate} > 23 and ${month_calculate} <= 29)
1 Yes
0 No
0.1 Don't Know/No response
LF42 (required) 42. Does the child ask you for help using signs or words when he/she cannot do something on his/her own (e.g., to
reach an object up high)?
Question relevant when: ( ${month_calculate} > 23 and ${month_calculate} <= 29)
1 Yes
0 No
0.1 Don't Know/No response
LF43 (required) 43. Does the child try to repeat sounds or words said by other people?
Question relevant when: ( ${month_calculate} > 23 and ${month_calculate} <= 29)
1 Yes
0 No
0.1 Don't Know/No response
LF44 (required)
44. Can the child climb onto an object such as a chair or bench?
Question relevant when: ( ${LF39} + ${LF40} + ${LF41} + ${LF42} + ${LF43} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF45 (required) 45. Can the child figure out how to turn a spoon or object if you give it to him/her the wrong way around?
Question relevant when: ( ${LF40} + ${LF41} + ${LF42} + ${LF43} + ${LF44} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF46 (required) 46. Does the child stop at least briefly when told “no” or “stop that"?
Question relevant when: ( ${LF41} + ${LF42} + ${LF43} + ${LF44} + ${LF45} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF47 (required)
47. Can the child kick a ball or other round object forward using his/her foot?
Question relevant when: ( ${LF42} + ${LF43} + ${LF44} + ${LF45} + ${LF46} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF48 (required) 48. Can the child point to a person or object when asked (e.g., “Where is mama?" or "Where is the ball?")?
Question relevant when: ( ${LF43} + ${LF44} + ${LF45} + ${LF46} + ${LF47} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF49 (required)
49. Can the child drink from a cup (without a lid) on his/her own without spilling?
Question relevant when: ( ${LF44} + ${LF45} + ${LF46} + ${LF47} + ${LF48} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF50 (required) 50. Does the child imitate animal or other sounds (e.g., "vroom" for a car, "moo" for a cow)?
Question relevant when: ( ${LF45} + ${LF46} + ${LF47} + ${LF48} + ${LF49} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF51 (required)
51. Can the child run more than a few steps without falling or bumping into objects?
Question relevant when: ( ${LF46} + ${LF47} + ${LF48} + ${LF49} + ${LF50} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF52 (required)
52. Can the child draw a line or shape on paper with a pen or crayon, or in the dirt with a stick?
Question relevant when: ( ${month_calculate} >= 30) or (( ${LF47} + ${LF48} + ${LF49} + ${LF50} + ${LF51} ) >=
1)
1 Yes
0 No
0.1 Don't Know/No response
LF53 (required) 53. Can the child answer simple questions (e.g., “Do you want water?”) by saying "yes" or "no", rather than nodding?
Question relevant when: ( ${month_calculate} >= 30) or (( ${LF48} + ${LF49} + ${LF50} + ${LF51} + ${LF52} ) >=
1)
1 Yes
0 No
0.1 Don't Know/No response
Field Question Answer
LF54 (required)
54. Can the child stack three or more small objects (e.g., blocks, cups, bottle caps) on top of each other?
Question relevant when: ( ${month_calculate} >= 30) or (( ${LF49} + ${LF50} + ${LF51} + ${LF52} + ${LF53} ) >=
1)
1 Yes
0 No
0.1 Don't Know/No response
LF55 (required) 55. Does the child imitate others' behaviors (e.g., washing hands or dishes)?
Question relevant when: ( ${month_calculate} >= 30) or (( ${LF50} + ${LF51} + ${LF52} + ${LF53} + ${LF54} ) >=
1)
1 Yes
0 No
0.1 Don't Know/No response
LF56 (required) 56. Does the child sometimes share things (e.g., food, toys) with others without being told?
Question relevant when: ( ${month_calculate} >= 30) or (( ${LF51} + ${LF52} + ${LF53} + ${LF54} + ${LF55} ) >=
1 Yes
0 No
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Field Question Answer
1) 0.1 Don't Know/No response
LF57 (required) 57. Can the child follow orders or instructions that have more than one part (e.g., "Go get water and go to bed")?
Question relevant when: ( ${LF52} + ${LF53} + ${LF54} + ${LF55} + ${LF56} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF58 (required) 58. Can the child say five or more separate words (e.g., names like "Mama" or objects like "ball")?
Question relevant when: ( ${LF53} + ${LF54} + ${LF55} + ${LF56} + ${LF57} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF59 (required) 59. Is the child kind to younger children (e.g., speaks to them nicely and touches them gently)?
Question relevant when: ( ${LF54} + ${LF55} + ${LF56} + ${LF57} + ${LF58} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF60 (required)
60. Can the child walk on an uneven surface (e.g., a bumpy or steep road) without falling?
Question relevant when: ( ${LF55} + ${LF56} + ${LF57} + ${LF58} + ${LF59} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF61 (required) 61. Does the child listen to someone telling a story with interest?
Question relevant when: ( ${LF56} + ${LF57} + ${LF58} + ${LF59} + ${LF60} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF62 (required) 62. Can the child ask for something (e.g., food, water) by name when he/she wants it?
Question relevant when: ( ${LF57} + ${LF58} + ${LF59} + ${LF60} + ${LF61} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF63 (required) 63. Does the child involve others in play (i.e., play interactive games with other children)?
Question relevant when: ( ${LF58} + ${LF59} + ${LF60} + ${LF61} + ${LF62} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF64 (required) 64. Can the child correctly name at least one family member other than mom and dad (e.g., name of brother, sister,
aunt, uncle)?
Question relevant when: ( ${LF59} + ${LF60} + ${LF61} + ${LF62} + ${LF63} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF65 (required) 65. Does the child play by pretending objects are something else (e.g., imagining a bottle is a doll, a stone is a car, or
a spoon is an airplane)?
Question relevant when: ( ${LF60} + ${LF61} + ${LF62} + ${LF63} + ${LF64} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF66 (required) 66. Does the child show sympathy or look concerned when others are hurt or sad?
Question relevant when: ( ${LF61} + ${LF62} + ${LF63} + ${LF64} + ${LF65} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF67 (required)
67. Can the child walk backwards?
Question relevant when: ( ${LF62} + ${LF63} + ${LF64} + ${LF65} + ${LF66} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF68 (required) 68. Does the child show curiosity to learn new things (e.g., by asking questions or exploring a new area)?
Question relevant when: ( ${LF63} + ${LF64} + ${LF65} + ${LF66} + ${LF67} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF69 (required)
69. Can the child feed him/herself using a spoon or other utensil without spilling?
Question relevant when: ( ${LF64} + ${LF65} + ${LF66} + ${LF67} + ${LF68} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF70 (required) 70. Can the child concentrate on one task (e.g., playing with friends, eating meal) for 20 minutes?
Question relevant when: ( ${LF65} + ${LF66} + ${LF67} + ${LF68} + ${LF69} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF71 (required) 71. Does the child know the names of at least two body parts (e.g., arm, eye, or nose)?
Question relevant when: ( ${LF66} + ${LF67} + ${LF68} + ${LF69} + ${LF70} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF72 (required) 72. If you show the child an object he/she knows well (e.g., a cup or animal), can he/she consistently name it?
Question relevant when: ( ${LF67} + ${LF68} + ${LF69} + ${LF70} + ${LF71} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF73 (required) 73. Can the child speak using short sentences of two words that go together (e.g., “Mama go” or "Dada eat”)?
Question relevant when: ( ${LF68} + ${LF69} + ${LF70} + ${LF71} + ${LF72} ) >= 1
1 Yes
Field Question Answer
0 No
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0.1 Don't Know/No response
LF74 (required) 74. Can the child use a tool (e.g., a stick or spoon) to reach objects that are far away?
Question relevant when: ( ${LF69} + ${LF70} + ${LF71} + ${LF72} + ${LF73} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF75 (required) 75. Can the child indicate when he/she needs to go to the potty?
Question relevant when: ( ${LF70} + ${LF71} + ${LF72} + ${LF73} + ${LF74} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF76 (required) 76. Can the child say ten or more separate words (e.g., names like "Mama" or objects like "ball")?
Question relevant when: ( ${LF71} + ${LF72} + ${LF73} + ${LF74} + ${LF75} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF77 (required)
77. Can the child remove an item of clothing (e.g., take off his/her shirt)?
Question relevant when: ( ${LF72} + ${LF73} + ${LF74} + ${LF75} + ${LF76} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF78 (required) 78. Can the child tell you when he/she is tired or hungry?
Question relevant when: ( ${LF73} + ${LF74} + ${LF75} + ${LF76} + ${LF77} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF79 (required) 79. Does the child usually finish an activity he/she enjoys (e.g., a game or book)?
Question relevant when: ( ${LF74} + ${LF75} + ${LF76} + ${LF77} + ${LF78} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF80 (required) 80. Can the child easily switch back and forth between activities (e.g., go back to a game after being interrupted)?
Question relevant when: ( ${LF75} + ${LF76} + ${LF77} + ${LF78} + ${LF79} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF81 (required) 81. Can the child sing a short song or repeat parts of a rhyme from memory by him/herself?
Question relevant when: ( ${LF76} + ${LF77} + ${LF78} + ${LF79} + ${LF80} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF82 (required)
82. Can the child jump with both feet leaving the ground?
Question relevant when: ( ${LF77} + ${LF78} + ${LF79} + ${LF80} + ${LF81} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF83 (required) 83. Can the child speak using sentences of three or more words that go together (e.g., "I want water" or "The house is
big")?
Question relevant when: ( ${LF78} + ${LF79} + ${LF80} + ${LF81} + ${LF82} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF84 (required) 84. Can the child whisper?
Question relevant when: ( ${LF79} + ${LF80} + ${LF81} + ${LF82} + ${LF83} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF85 (required) 85. Does the child greet neighbors or other people he/she knows without being told (e.g., by saying hello or gesturing
hello)?
Question relevant when: ( ${LF80} + ${LF81} + ${LF82} + ${LF83} + ${LF84} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF86 (required)
86. Can the child unscrew the lid from a bottle or jar?
Question relevant when: ( ${LF81} + ${LF82} + ${LF83} + ${LF84} + ${LF85} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF87 (required) 87. Can the child correctly ask questions using any of the words "what," "which," "where," or "who"?
Question relevant when: ( ${LF82} + ${LF83} + ${LF84} + ${LF85} + ${LF86} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF88 (required) 88. Can the child correctly use any of the words "I," "you," "she," or "he" (e.g., "I go to store," or "He eats rice")?
Question relevant when: ( ${LF83} + ${LF84} + ${LF85} + ${LF86} + ${LF87} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF89 (required) 89. Does the child pronounce most of his/her words correctly?
Question relevant when: ( ${LF84} + ${LF85} + ${LF86} + ${LF87} + ${LF88} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF90 (required) 90. Can the child count up to five objects (e.g., fingers, people)?
Question relevant when: ( ${LF85} + ${LF86} + ${LF87} + ${LF88} + ${LF89} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
LF91 (required) 91. Does the child ask about familiar people other than parents when they are not there (e.g., "Where is the
neighbor?")?
Question relevant when: ( ${LF86} + ${LF87} + ${LF88} + ${LF89} + ${LF90} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
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Field Question Answer
LF92 (required) 92. If you show the child two objects or people of different size, can he/she tell you which one is the big one and which
is the small one?
Question relevant when: ( ${LF87} + ${LF88} + ${LF89} + ${LF90} + ${LF91} ) >= 1
1 Yes
0 No
0.1 Don't Know/No response
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Field Question Answer
LF93 (required)
93. Can the child stand on one foot for several seconds without holding on to a person or object (e.g., wall or
furniture)?
Question relevant when: ( ${LF88} + ${LF89} + ${LF90} + ${LF91} + ${LF92} ) >= 1
1 Yes
0 No
0.1 Don't Know/No
response
LF94 (required) 94. Can the child identify at least one color (e.g., red, blue, yellow)?
Question relevant when: ( ${LF89} + ${LF90} + ${LF91} + ${LF92} + ${LF93} ) >= 1
1 Yes
0 No
0.1 Don't Know/No
response
LF95 (required) 95. Does the child regularly use describing words such as "fast," "short," "hot," "fat," or "beautiful" correctly?
Question relevant when: ( ${LF90} + ${LF91} + ${LF92} + ${LF93} + ${LF94} ) >= 1
1 Yes
0 No
0.1 Don't Know/No
response
LF96 (required) 96. If you point to an object, can the child correctly use the words "on," "in," or "under" to describe where it is (e.g.,
"The cup is on the table" instead of "The cup is in the table.")
Question relevant when: ( ${LF91} + ${LF92} + ${LF93} + ${LF94} + ${LF95} ) >= 1
1 Yes
0 No
0.1 Don't Know/No
response
LF97 (required) 97. Can the child explain in words what common objects like a cup or chair are used for?
Question relevant when: ( ${LF92} + ${LF93} + ${LF94} + ${LF95} + ${LF96} ) >= 1
1 Yes
0 No
0.1 Don't Know/No
response
LF98 (required)
98. Can the child dress him/herself (e.g., put on his/her pants and shirt without help)?
Question relevant when: ( ${LF93} + ${LF94} + ${LF95} + ${LF96} + ${LF97} ) >= 1
1 Yes
0 No
0.1 Don't Know/No
response
LF99 (required) 99. Does the child ask "why" questions (e.g., "Why are you tall?")?
Question relevant when: ( ${LF94} + ${LF95} + ${LF96} + ${LF97} + ${LF98} ) >= 1
1 Yes
0 No
0.1 Don't Know/No
response
LF100 (required) 100. If you ask the child to give you three objects (e.g., stones, beans), does the child give you the correct amount?
Question relevant when: ( ${LF95} + ${LF96} + ${LF97} + ${LF98} + ${LF99} ) >= 1
1 Yes
0 No
0.1 Don't Know/No
response
LF101 (required) 101. Does the child usually put objects or toys back where they belong after using them?
Question relevant when: ( ${LF96} + ${LF97} + ${LF98} + ${LF99} + ${LF100} ) >= 1
1 Yes
0 No
0.1 Don't Know/No
response
LF102 (required) 102. Does the child frequently act impulsively or without thinking (e.g., running into the street without looking)?
Question relevant when: ( ${LF97} + ${LF98} + ${LF99} + ${LF100} + ${LF101} ) >= 1
0 Yes
1 No
0.1 Don't know
LF103 (required) 103. Does the child sometimes save things like candy or new toys for the future?
Question relevant when: ( ${LF98} + ${LF99} + ${LF100} + ${LF101} + ${LF102} ) >= 1
1 Yes
0 No
0.1 Don't Know/No
response
LF104 (required) 104. Can the child say what others like or dislike (e.g., "Mama doesn't like fruit," "Papa likes football")?
Question relevant when: ( ${LF99} + ${LF100} + ${LF101} + ${LF102} + ${LF103} ) >= 1
1 Yes
0 No
0.1 Don't Know/No
response
LF105 (required)
105. Can the child fasten and unfasten buttons without help?
Question relevant when: ( ${LF100} + ${LF101} + ${LF102} + ${LF103} + ${LF104} ) >= 1
1 Yes
0 No
0.1 Don't Know/No
response
LF106 (required) 106. Can the child talk about things that will happen in the future using correct language (e.g., "Tomorrow he will
attend school" or "Next week we will go to the market")?
Question relevant when: ( ${LF101} + ${LF102} + ${LF103} + ${LF104} + ${LF105} ) >= 1
1 Yes
0 No
0.1 Don't Know/No
response
LF107 (required) 107. Can the child talk about things that have happened in the past using correct language (e.g., "Yesterday I played 1 Yes
0 No
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Field Question Answer
with my friend" or "Last week she went to the market")?
Question relevant when: ( ${LF102} + ${LF103} + ${LF104} + ${LF105} + ${LF106} ) >= 1
0.1 Don't Know/No
response
LF108 (required) 108. Does the child know the names of any letters (e.g., A, B, C)?
Question relevant when: ( ${LF103} + ${LF104} + ${LF105} + ${LF106} + ${LF107} ) >= 1
1 Yes
0 No
0.1 Don't Know/No
response
Survey > Child Development Survey > CREDI: Mental Health
Group relevant when: ${subsets_completed} =1
generated_note_name_3011 Module: Mental Health
[ENUM]: The following questions should be answered by [fullname_caregiver]
LMH_note We have just a few more questions to answer. The rules for these are the same. Please continue to answer with "yes",
"no," or "don't know".
LMH1 (required) 1. Does the child often cry for no reason (e.g., when he/she is not hungry or tired)? 0 Yes
1 No
0.1 Don't know
LMH2 (required) 2. Does the child frequently complain of headaches or stomachaches when he/she is not physically ill? 0 Yes
Field Question Answer
LMH2 (required) 2. Does the child frequently complain of headaches or stomachaches when he/she is not physically ill? 1 No
0.1 Don't know
LMH3 (required) 3. Does the child become upset when you are not with him/her? 0 Yes
1 No
0.1 Don't know
LMH4 (required) 4. Does the child become very shy, afraid, or upset around strangers, even when you're with him/her? 0 Yes
1 No
0.1 Don't know
LMH5 (required) 5. Does the child cling excessively to his/her caregiver, even in a safe setting? 0 Yes
1 No
0.1 Don't know
LMH6 (required) 6. Can the child sit still when asked to by an adult (e.g., for two minutes)? 1 Yes
0 No
0.1 Don't Know/No
response
LMH7 (required) 7. Does the child cry or whine when he/she is made to wait for something he/she wants (e.g., toy or food)? 0 Yes
1 No
0.1 Don't know
LMH8 (required) 8. Does the child often kick, bite, or hit other children or adults? 0 Yes
1 No
0.1 Don't know
LMH9 (required) 9. Does the child become extremely withdrawn or shy in new situations? 0 Yes
1 No
0.1 Don't know
Survey > Child Development Survey > Health of children
Group relevant when: ${subsets_completed} =1
generated_note_name_3028 Module: Health of children
[ENUM]: The following questions should be answered by [fullname_caregiver]
generated_note_name_3029 Now, I would like ask you question about the health of the children.
sweet_potato (required) Did [fullname_child] consume orange flesh sweet potato during the last 7 days? 1 Yes
0 No
vitamin (required) Has [fullname_child] received a Vitamin A capsule in the last 6 months? 1 Yes, recorded on
card
2 Yes, no card
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Field Question Answer
present
3 Not recorded on
card
4 No, card not
present
-99 Don't know
vitamin_source (required) Where did the Vitamin A capsule come from?
Question relevant when: ${vitamin} =1
1 On routine visiti to
health
facility
2 Child health days
-66 Other
-99 Don't know
vitamin_source_ot (required) Specify:
Question relevant when: ${vitamin_source} =-66
Response constrained to: string-length(.) > 3
drugs (required) During the most recent child health day was [fullname_child] given drugs for intestinal worms like this? 1 Yes
0 No
-99 Don't know
diarrhea (required) Has [fullname_child] had diarrhea in the last 2 weeks?
Diarrhea is 3 or more loose or watery stools per day.
1 Yes
0 No
-99 Don't know
diarrhea_blood (required) Was there any blood in the stools?
Bloody diarrhea is 3 or more loose or watery stools with blood per day.
Question relevant when: ${diarrhea} =1
1 Yes
0 No
-99 Don't know
Survey > Child Development Survey > Health of children > gr_diarrhea
Group relevant when: ${diarrhea} =1
generated_note_name_3038 During the last episode of diarrhea, did [fullname_child] take any of the following as treatment?
diarrhea_treatment_1 (required) Fluid from ORS sachet and Zinc 1 Yes
0 No
-99 Don't know
diarrhea_treatment_2 (required) Reccomended homemade fluid (sugar/salt solution) 1 Yes
0 No
-99 Don't know
diarrhea_treatment_3 (required) Other, specify 1 Yes
0 No
-99 Don't know
diarrhea_treatment_3_ot (required) Specify:
Question relevant when: ${diarrhea_treatment_3} =1
Response constrained to: string-length(.) > 3
freq_drink (required) During the last episode of diarrhea, did [fullname_child] drink much less, about the same, or more than usual?
Question relevant when: ${diarrhea} =1
1 Much less/None
2 About the
same/Somewhat
less
3 More
-99 Don't know
freq_eat (required) During the last episode of diarrhea, did [fullname_child] eat much less, about the same, or more than usual?
Question relevant when: ${diarrhea} =1
0 None
1 Much less
2 Somewhat less
3 About the same
4 More
-99 Don't know
cough (required) Has [fullname_child] had cough during she/he breathed faster than usual with short quick breaths, or had difficulty
breathing in the last two weeks?
1 Yes
0 No
-99 Don't know
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Survey Information
survey_complete (required) (Z101) [ENUMERATOR] What is the status of the interview? 1 Complete
0 Incomplete
survey_uncomplete (required) [ENUMERATOR] Please explain
Question relevant when: ${survey_complete} =0
1 Child cannot
speak/wlak and
no other eligible
child
2 Respondent
shifted nolonger
stays in this village
3 Respondent
refused
(caregiver)
4 The target child
found to be
inneligible and no
other eligible
child
5 Child died
6 Child mentioned
does not exist
and no other
eligible
child in the HH
7 Child doesn’t
understand the
language
8 The child refused
(ie. sick, child is
distracted and not
willing to
participate)
-66 Other, specify
survey_uncomplete_explain (Z102) [ENUMERATOR] Please explain
Question relevant when: 0
survey_uncomplete_explain_ot (required) (Z102.1) Other, specify
Question relevant when: ${survey_uncomplete} =-66
survey_gps (Z107) [ENUMERATOR] Take the gps coordinates of the house.
GPS coordinates can only be collected when outside.
Question relevant when: ${consentgps} =1
survey_gps_place (required) (Z108) [ENUMERATOR] Where did you record the GPS coordinates?
Question relevant when: ${consentgps} =1
1 Household's house
0 I could not record
the GPS
coordinate
-66 Other, specify
survey_gps_place_osp (required) (Z109) Other, specify
Question relevant when: selected( ${survey_gps_place} ,'-66')
Response constrained to: string-length(.) > 3
interview_place (required) (Z110) [ENUMERATOR] Where did you interview the respondent?
Question relevant when: ${consentsurvey} >=1
1 Household's house
-66 Other, specify
interview_place_osp (required) (Z111) Other, specify
Question relevant when: selected( ${interview_place} ,'-66')
Response constrained to: string-length(.) > 3
survey_language_osp (required) (Z113) Other, specify
Question relevant when: selected( ${survey_language} ,'-66')
Response constrained to: string-length(.) > 3
survey_comments (Z114) [ENUMERATOR] Please use this text box to make any comments about the survey