CLIMSPEECH is one of a set of variables in the Health Status and Limitation of Activities section of the NHIS Family Core. The question, "What conditions or health problems cause [person's] limitations?," (with speech problem as a possible answer) comes only if specific answers are provided to a sequence of preceding questions that vary according to the age of the subject.
These questions, and the necessary answers, are:
Persons under age 5
If there is an
affirmative answer to the question, "Is [person] limited in the kind or amount of play activities he or she can do because of a physical, mental, or emotional problem?" (
LAPLAYAL and
LAPLAYAM), then the question for which a speech problem is a possible answer
is asked.
Persons age 3-17
If there is an
affirmative answer to the question, "Because of a physical, mental or emotional problem, [does] [person] need the help of other persons with personal care needs, such as eating, bathing, dressing, or getting around inside this home?" (
LADL), then the question for which a speech problem is a possible answer
is asked.
Persons under age 18
If there is an
affirmative answer to the question, "Does [person] receive Special Educational or Early Intervention Services?" (
LASPED), then the question for which a speech problem is a possible answer
is asked.
If there is an
affirmative answer to the question, "Because of a health problem, [does] [person] have difficulty walking without using any special equipment?" (
LAWALK), then the question for which a speech problem is a possible answer
is asked.
If there is an
affirmative answer to the question, "[Is] [person] limited in any way because of difficulty remembering or because [they] experience periods of confusion?" (
LAMEMRY), then the question for which a speech problem is a possible answer
is asked.
If there is an
affirmative answer to the question, "Is [person] limited in any way in any activities because of physical, mental or emotional problems?" (
LAOTHER), then the question for which a speech problem is a possible answer
is asked.
The following definitions provide information about various concepts used in the sequence of questions identified above:
"Limited": According to the Field Representative's Manuals for 1997 forward, "limited" refers to a person's ability to "only partially perform" a specific activity, perform that activity "only part of the time," or not perform that activity at all. Moreover, interviewers were instructed not to define this term to respondents. If asked for a definition, interviewers were to emphasize that the survey is interested in whether the respondent believes that the person is limited in the specific activity.
"Health Problem": According to the Field Representative's Manuals for 1997 forward, a "health problem" is respondent defined. The 2001 forward Manuals go on to state that, generally speaking, "it is any condition, physical, mental, or emotional, which causes limitation in activity." Moreover, the Manuals say that it is not important for the respondent to differentiate between a "condition" and a "health problem."
"Condition": According to the Field Representative's Manuals for 1997 forward, the presence of a condition is determined by the respondent's perception of a health problem of any kind. The 2001 forward Manuals go on to add that a condition is "a departure from physical, mental or emotional well-being," and that such departures "are specific health problems such as missing an extremity or organ, the name of a disease, a symptom, the result of an accident or some other type of impairment. Also included are vague disorders and health problems not always thought of as 'illnesses,' such as alcoholism, drug-related problems, senility, depression, [or] anxiety."
"Problem": The Field Representative's Manuals for 1997 forward defined a problem as the respondent's perception "of a chronic, perhaps permanent, departure from physical, mental or emotional well being."
"
In any way": The 1997-2000
Field Representative's Manuals define the expression "in any way" (such as in the question "[Is] [person] limited in any way because of difficulty remembering or because [he or she] experience[s] periods of confusion?" (
LAMEMRY)) as referring to "activities that are normal for most people of that age."
"Help from Another Person": According to the Field Representative's Manuals for 1997 forward, help from another person "is considered to be hands on assistance with performing an activity. An 'other person' may be a friend, relative, paid helper, volunteer from an agency or organization or anyone else who helps the family member in doing the activities mentioned. He or she may be a household member or a non-household member."
"Special Education and Early Intervention Services": According to the Field Representative's Manuals for 1997 forward, special education and early intervention services "are designed to meet the needs of children with special needs and/or disabilities." Special Education involves special teaching programs, "paid for by the public school system" that may take place at "a regular school, a special school, a private school, at home, or at a hospital." The Manuals for 2001 forward go on to state that early "intervention services are designed for very young children, and may include, but are not limited to medical and social services, parental counseling, and therapy that may be provided at the child's home, a medical center, a day care center, or other place."
"Special Equipment": According to the Field Representative's Manuals for 1997 forward, special equipment includes "any device, tool, utensil, instrument, implement, etc. used as an aid in performing an activity because of a physical, mental or emotional problem."
