Form Structure: Adaptive Behavior Assessment System II (ABAS II) Parent Form - mod followup CHAI

Short Name:
ABASP_mod_FU_CHAI
Description:
The ABAS-II provides a comprehensive, norm-referenced assessment of the adaptive behavior and skills of individuals from birth to age 89. The test's ease of administration and scoring, and wide age range have resulted in its widespread use for a large number of assessment purposes. Scores for each area allow you to evaluate areas of functioning, determine strengths and weaknesses, and specify training goals.
Disease:
Traumatic Brain Injury
Organization:
University of Washington
Required Program Form:
No
Standardization:
Standard Modified
Publication Date:
2014-12-17
Version:
1.0
Date Created:
2014-12-17
Created By:
Number of Data Elements:
59
eForms:
N

Attached Data Elements

# Title Short Description Variable Name Required? Type
1 GUID   Global Unique ID which uniquely identifies a subject GUID Required CDE
2 Subject identifier number   An identification number assigned to the participant/subject within a given protocol or a study. SubjectIDNum Optional CDE
3 Age in years   Value for participant's subject age recorded in years. AgeYrs Recommended CDE
4 Visit date   Actual interview or visit date VisitDate Recommended CDE
5 Site name   The name of the site for the study SiteName Recommended CDE
6 Days since baseline   The number of days since baseline DaysSinceBaseline Optional CDE
7 Case control indicator   Indicator of whether subject is in the case or control arm of the study. CaseContrlInd Optional CDE
8 General notes text   General notes GeneralNotesTxt Optional CDE

Additional Element Groups

Listed below are your additional element groups.

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CHAI Administrative Variables (Repeat Infinitely)

# Title Short Description Variable Name Required? Type
1 Children's Health After Injury (CHAI) Study - Follow Up Type  Month of follow up interview with the Children's Health After Injury (CHAI) Study CHAIFollowUpTyp Recommended UDE
2 Children's Health After Injury (CHAI) Study - Interview Method  Method of participant interview, phone or web, with the Children's Health After Injury (CHAI) Study CHAIInterviewMethd Recommended UDE
3 Children's Health After Injury (CHAI) Study - Respondent  Answers were given by parent or adolescent respondent with the Children's Health After Injury (CHAI) Study CHAIParentChildRespond Recommended UDE

Communication (Repeat Infinitely)

# Title Short Description Variable Name Required? Type
1 Adaptive Behavior Assessment System II (ABAS II) Parent Form - says the names of other people frequency - mod followup CHAI  Frequency that child says the names of other people (ABAS II Parent Form - Communication) - mod followup CHAI ABASPSayPrsnName2FreqModFUCHAI Recommended UDE
2 Adaptive Behavior Assessment System II (ABAS II) Parent Form - shakes head or says 'yes' or 'no' frequency - mod followup CHAI  Frequency that child shakes head or says 'yes' or 'no' in response to a simple question (ABAS II Parent Form - Communication) - mod followup CHAI ABASPShakeHeadFreqModFUCHAI Recommended UDE
3 Adaptive Behavior Assessment System II (ABAS II) Parent Form - says 'hello' and 'good-bye' frequency - mod followup CHAI  Frequency that child says 'hello' and 'good-bye' to others (ABAS II Parent Form - Communication) - mod followup CHAI ABASPSayHiByeFreqModFUCHAI Recommended UDE
4 Adaptive Behavior Assessment System II (ABAS II) Parent Form - can name 20+ objects frequency - mod followup CHAI  Frequency that child names 20 or more familiar objects (ABAS II Parent Form - Communication) - mod followup CHAI ABASPSay20ObjctNmFreqModFUCHAI Recommended UDE
5 Adaptive Behavior Assessment System II (ABAS II) Parent Form - tells others about their favorite activity frequency - mod followup CHAI  Frequency that child tells parents, friends, or others about their favorite activities (ABAS II Parent Form - Communication) - mod followup CHAI ABASPTellsFavAct2FreqModFUCHAI Recommended UDE
6 Adaptive Behavior Assessment System II (ABAS II) Parent Form - uses sentences with verb and noun frequency - mod followup CHAI  Frequency that child uses sentences with a noun and a verb (ABAS II Parent Form - Communication) - mod followup CHAI ABASPCompltSentncFreqModFUCHAI Recommended UDE
7 Adaptive Behavior Assessment System II (ABAS II) Parent Form - speaks clearly frequency - mod followup CHAI  Frequency that child speaks clearly and distinctly (ABAS II Parent Form - Communication) - mod followup CHAI ABASPSpeakClearFreqModFUCHAI Recommended UDE
8 Adaptive Behavior Assessment System II (ABAS II) Parent Form - looks at faces when talking frequency - mod followup CHAI  Frequency that child looks at others' faces when they are talking (ABAS II Parent Form - Communication) - mod followup CHAI ABASPLookFaceTalkFreqModFUCHAI Recommended UDE
9 Adaptive Behavior Assessment System II (ABAS II) Parent Form - pays attention during family discussions frequency - mod followup CHAI  Frequency that child pays attention during family discussions for as long as needed (ABAS II Parent Form - Communication) - mod followup CHAI ABASPPaysAttnFmlyFreqModFUCHAI Recommended UDE
10 Adaptive Behavior Assessment System II (ABAS II) Parent Form - answers phone appropriately frequency - mod followup CHAI  Frequency that child answers the telephone appropriately (ABAS II Parent Form - Communication) - mod followup CHAI ABASPAnswerPhoneFreqModFUCHAI Recommended UDE
11 Adaptive Behavior Assessment System II (ABAS II) Parent Form - listens closely for at least 5 minute frequency - mod followup CHAI  Frequency that child listens closely for at least five minutes when people talk (ABAS II Parent Form - Communication) - mod followup CHAI ABASPListen5MinFreqModFUCHAI Recommended UDE
12 Adaptive Behavior Assessment System II (ABAS II) Parent Form - nods when others talk frequency - mod followup CHAI  Frequency that child nods or smiles to encourage others when they are talking (ABAS II Parent Form - Communication) - mod followup CHAI ABASPNodOthrTalkFreqModFUCHAI Recommended UDE
13 Adaptive Behavior Assessment System II (ABAS II) Parent Form - repeats stories or jokes frequency - mod followup CHAI  Frequency that child repeats stories or jokes after hearing them from others (ABAS II Parent Form - Communication) - mod followup CHAI ABASPRepeatStoryFreqModFUCHAI Recommended UDE
14 Adaptive Behavior Assessment System II (ABAS II) Parent Form - says irregular plural nouns frequency - mod followup CHAI  Frequency that child says irregular plural nouns (ABAS II Parent Form - Communication) - mod followup CHAI ABASPSayPlurlNounFreqModFUCHAI Recommended UDE
15 Adaptive Behavior Assessment System II (ABAS II) Parent Form - ends conversations appropriately frequency - mod followup CHAI  Frequency that child ends conversations appropriately (ABAS II Parent Form - Communication) - mod followup CHAI ABASPEndConvers2FreqModFUCHAI Recommended UDE
16 Adaptive Behavior Assessment System II (ABAS II) Parent Form - takes turns talking during conversations frequency - mod followup CHAI  Frequency that child takes turns talking during conversations with people (ABAS II Parent Form - Communication) - mod followup CHAI ABASPTakeTurnTalkFreqModFUCHAI Recommended UDE
17 Adaptive Behavior Assessment System II (ABAS II) Parent Form - gives multi-step verbal instructions frequency - mod followup CHAI  Frequency that child gives verbal instructions that involve two or more steps or activities (ABAS II Parent Form - Communication) - mod followup CHAI ABASPComplInstrctFreqModFUCHAI Recommended UDE
18 Adaptive Behavior Assessment System II (ABAS II) Parent Form - can state own phone number frequency - mod followup CHAI  Frequency that child states their own telephone number (ABAS II Parent Form - Communication) - mod followup CHAI ABASPSayPhoneNumFreqModFUCHAI Recommended UDE
19 Adaptive Behavior Assessment System II (ABAS II) Parent Form - starts conversations of interest with others frequency - mod followup CHAI  Frequency that child starts conversations on topics of interest to others (ABAS II Parent Form - Communication) - mod followup CHAI ABASPStartConvoFreqModFUCHAI Recommended UDE
20 Adaptive Behavior Assessment System II (ABAS II) Parent Form - talks about realistic future goals frequency - mod followup CHAI  Frequency that child talks about realistic future educational or career goals (ABAS II Parent Form - Communication) - mod followup CHAI ABASPTalkFutrGoalFreqModFUCHAI Recommended UDE
21 Adaptive Behavior Assessment System II (ABAS II) Parent Form - can call local phone numbers frequency - mod followup CHAI  Frequency that child places local telephone calls (ABAS II Parent Form - Communication) - mod followup CHAI ABASPMakePhonCallFreqModFUCHAI Recommended UDE
22 Adaptive Behavior Assessment System II (ABAS II) Parent Form - can state own home address with zip code frequency - mod followup CHAI  Frequency that child states home address, including zip code (ABAS II Parent Form - Communication) - mod followup CHAI ABASPKnowAddrsZipFreqModFUCHAI Recommended UDE
23 Adaptive Behavior Assessment System II (ABAS II) Parent Form - answers complex questions frequency - mod followup CHAI  Frequency that child answers complex questions that require careful thoughts and opinions (ABAS II Parent Form - Communication) - mod followup CHAI ABASPComplxQuestnFreqModFUCHAI Recommended UDE
24 Adaptive Behavior Assessment System II (ABAS II) Parent Form - uses up-to-date information in current events discussion frequency - mod followup CHAI  Frequency that child uses up-to-date information to discuss current events (ABAS II Parent Form - Communication) - mod followup CHAI ABASPDiscussEventFreqModFUCHAI Recommended UDE

Self Care (Repeat Infinitely)

# Title Short Description Variable Name Required? Type
1 Adaptive Behavior Assessment System II (ABAS II) Parent Form - uses bathroom without help frequency - mod followup CHAI  Frequency that child uses restroom at home without help (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPUsBathrmAlonFreqModFUCHAI Recommended UDE
2 Adaptive Behavior Assessment System II (ABAS II) Parent Form - uses fork to eat solid food frequency - mod followup CHAI  Frequency that child uses a fork to eat solid food (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPUseForkEatFreqModFUCHAI Recommended UDE
3 Adaptive Behavior Assessment System II (ABAS II) Parent Form - washes hands with soap frequency - mod followup CHAI  Frequency that child washes hands with soap (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPWashHandSoapFreqModFUCHAI Recommended UDE
4 Adaptive Behavior Assessment System II (ABAS II) Parent Form - brushes teeth frequency - mod followup CHAI  Frequency that child brushes teeth (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPBrushTeethFreqModFUCHAI Recommended UDE
5 Adaptive Behavior Assessment System II (ABAS II) Parent Form - blows and wipes nose with tissue frequency - mod followup CHAI  Frequency that child blows and wipes nose with tissue or handkerchief (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPBlowNoseFreqModFUCHAI Recommended UDE
6 Adaptive Behavior Assessment System II (ABAS II) Parent Form - drinks without spilling frequency - mod followup CHAI  Frequency that child drinks liquids without spilling (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPDrinkNoSpillFreqModFUCHAI Recommended UDE
7 Adaptive Behavior Assessment System II (ABAS II) Parent Form - has pleasant breath frequency - mod followup CHAI  Frequency that child has pleasant breath (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPPlesntBreathFreqModFUCHAI Recommended UDE
8 Adaptive Behavior Assessment System II (ABAS II) Parent Form - buttons own clothing frequency - mod followup CHAI  Frequency that child buttons their own clothing (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPButtonClotheFreqModFUCHAI Recommended UDE
9 Adaptive Behavior Assessment System II (ABAS II) Parent Form - puts shoes on correct feet frequency - mod followup CHAI  Frequency that child puts shoes on correct feet (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPShoesCorrectFreqModFUCHAI Recommended UDE
10 Adaptive Behavior Assessment System II (ABAS II) Parent Form - bathes daily frequency - mod followup CHAI  Frequency that child bathes daily (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPBathesDailyFreqModFUCHAI Recommended UDE
11 Adaptive Behavior Assessment System II (ABAS II) Parent Form - dresses themselves frequency - mod followup CHAI  Frequency that child dresses themselves (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPDressesSelf2FreqModFUCHAI Recommended UDE
12 Adaptive Behavior Assessment System II (ABAS II) Parent Form - closes and locks public restroom doors frequency - mod followup CHAI  Frequency that child closes and locks door before using public restrooms (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPLockRestrmDrFreqModFUCHAI Recommended UDE
13 Adaptive Behavior Assessment System II (ABAS II) Parent Form - cleans themselves when dirty frequency - mod followup CHAI  Frequency that child cleans or brushes themselves off if muddy or dirty (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPCleanIfDirtyFreqModFUCHAI Recommended UDE
14 Adaptive Behavior Assessment System II (ABAS II) Parent Form - straightens clothes frequency - mod followup CHAI  Frequency that child fastens and straightens clothing before leaving restroom (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPNeatClothesFreqModFUCHAI Recommended UDE
15 Adaptive Behavior Assessment System II (ABAS II) Parent Form - keeps hair neat with brush or comb frequency - mod followup CHAI  Frequency that child keeps hair neat during the day by brushing or combing (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPBrushHairFreqModFUCHAI Recommended UDE
16 Adaptive Behavior Assessment System II (ABAS II) Parent Form - ties own shoes frequency - mod followup CHAI  Frequency that child ties their own shoes (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPTieOwnShoeFreqModFUCHAI Recommended UDE
17 Adaptive Behavior Assessment System II (ABAS II) Parent Form - uses public restroom alone frequency - mod followup CHAI  Frequency that child uses public restroom alone (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPUsPublicBathFreqModFUCHAI Recommended UDE
18 Adaptive Behavior Assessment System II (ABAS II) Parent Form - washes own hair frequency - mod followup CHAI  Frequency that child washes their own hair (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPWashOwnHair2FreqModFUCHAI Recommended UDE
19 Adaptive Behavior Assessment System II (ABAS II) Parent Form - uses hot and cold water for bathing frequency - mod followup CHAI  Frequency that child combines hot and cold water for shower or bath (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPUsHotColdH2OFreqModFUCHAI Recommended UDE
20 Adaptive Behavior Assessment System II (ABAS II) Parent Form - washes sink after brushing teeth frequency - mod followup CHAI  Frequency that child washes and rinses sink after brushing teeth (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPWashSinkAftrFreqModFUCHAI Recommended UDE
21 Adaptive Behavior Assessment System II (ABAS II) Parent Form - cleans under fingernails frequency - mod followup CHAI  Frequency that child cleans under fingernails (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPCleanNailsFreqModFUCHAI Recommended UDE
22 Adaptive Behavior Assessment System II (ABAS II) Parent Form - gets out of bed by themselves frequency - mod followup CHAI  Frequency that child gets out of bed on time by themselves (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPWakesSelfFreqModFUCHAI Recommended UDE
23 Adaptive Behavior Assessment System II (ABAS II) Parent Form - cuts food into small pieces frequency - mod followup CHAI  Frequency that child cuts meat or other foods into bite sized pieces (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPCutFoodSmallFreqModFUCHAI Recommended UDE
24 Adaptive Behavior Assessment System II (ABAS II) Parent Form - cuts nails regularly frequency - mod followup CHAI  Frequency that child cuts or files their own fingernails and toenails on a regular basis (ABAS II Parent Form - Self Care) - mod followup CHAI ABASPCutNailReglrFreqModFUCHAI Recommended UDE