Survey Text

2016
2012
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2016
Survey form view entire document:  text  image
Question ID: CBL.050_00.000

Instrument Variable Name: CBALDGN2
Questionnaire File Name: Sample Child
Question Text:
What diagnoses or reasons were you told caused [fill1: S.C. name]'s balance or dizziness problems?
*Enter all that apply, separate with commas.
01 Developmental motor coordination disorder (?clumsy? child)
02 Diabetes (?juvenile diabetes?)
03 Ear infection(s) ? otitis media, fluid, viral labrynthitis
04 Headache, including migraine
05 Crystals ? loose or dislodged in the ear
06 Blurred vision with head motion, ?bouncing? or rapid eye movements
07 Benign positional or paroxysmal vertigo (BPV)
08 Anxiety, including panic syndrome
09 Genetic syndrome, such as Usher?s or Waardenburg Syndrome
10 Depression or child psychiatric disorder
11 Head/neck injury or concussion
12 Low blood pressure (hypotension)
13 Malformation of the ear
14 Meniere?s disease
15 Neurological, such as cerebral palsy, seizure(s), etc.
16 Nutritional, such as low blood sugar (metabolic problem)
17 Side effects from medications (antibiotics, etc.)
18 Other health condition or cause
97 Refused
99 Don't know
Universe Text: Sample children 3+ who have ever been told a diagnosis for their balance or dizziness problems
Skip Instructions:
(1-18,R,D) [goto CBALPART]

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2012
Survey form view entire document:  text  image
Question ID:: CBL.045_00.000

Instrument Variable Name:: CBALDGHP
QuestionText:
Did a doctor or other health professional EVER tell you a diagnosis or reason for {fill1: S.C. name}'s dizziness or balance problems?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: Sample children 3+ who have had episodes of balance problems or dizziness in the past 12 months
SkipInstructions:
(1) [goto CBALDIGN]
(2,R,D) [goto CBALPART]
Question ID:: CBL.050_00.000

Instrument Variable Name:: CBALDIGN
QuestionText:
What diagnoses or reasons were you told caused {fill1: S.C. name}'s balance or dizziness problems?
*Enter all that apply, separate with commas.
01 Ear infections (inner ear infection, otitis media, fluid in ears)
02 Vision problems/Blurred vision
03 Positional dizziness or vertigo (BPPV)
04 Severe headaches or migraine
05 Head or neck injury or concussion
06 Neurologic disorders including seizures, stroke, or brain tumors
07 Developmental motor coordination disorder ("clumsy" child)
08 Malformation of the ear
09 Other genetic cause (Asperger Syndrome, Usher's Syndrome, etc.)
10 Metabolic problem, such as "low blood sugar" (hypoglycemia)
11 Prescription medication or drugs
12 Other
97 Refused
99 Don't Know
UniverseText: Sample children 3+ who have ever been told a diagnosis for their balance problem or dizziness
SkipInstructions:
(1-12,R,D) [goto CBALPART]