Using your usual language, do you have difficulty communicating, for example, understanding or
being understood?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Sample Adults 18+

1-4,RF,DK [goto next section]

Using your usual language, do you have difficulty communicating, for example, understanding or being understood?
Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Sample Adults 18+

1-4,RF,DK [goto COMUSESL_A]

Using your usual language, do you have difficulty communicating, for example, understanding or
being understood?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Sample Adults 18+

1-4,RF,DK [goto next section]

Using your usual language, do you have difficulty communicating, for example, understanding or being understood?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Sample Adults 18+

1-4,RF,DK = [goto next section]

Instrument Variable Name: COM_SS
Questionnaire File Name: Sample Adult
Question Text:

Using your usual language, do you have difficulty communicating, for example, understanding or being understood?
Would you say no difficulty, some difficulty, a lot of difficulty, or are you unable to do this?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all/unable to do
7 Refused
9 Don't know

Universe Text: Sample adults 18+
Skip Instructions:

(1-4,R,D) goto COM_2

Instrument Variable Name: COM_SS
Question Text:

Using your usual language, do you have difficulty communicating, for example, understanding or being understood? Would you say no difficulty, some difficulty, a lot of difficulty, or are you unable to do this?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all/unable to do
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1-4,R,D) go to COM_2

Instrument Variable Name: COM_SS
Question Text:

Using your usual language, do you have difficulty communicating, for example, understanding or being understood? Would you say no difficulty, some difficulty, a lot of difficulty, or are you unable to do this?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all/unable to do
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1-4,R,D) go to COM_2

Instrument Variable Name: COM_SS
Question Text:

Using your usual language, do you have difficulty communicating, for example, understanding or being understood? Would you say no difficulty, some difficulty, a lot of difficulty, or are you unable to do this?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all/unable to do
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1-4,R,D) go to COM_2

Instrument Variable Name: COM_SS
Question Text:

Using your usual language, do you have difficulty communicating, for example, understanding or being understood? Would you say no difficulty, some difficulty, a lot of difficulty, or are you unable to do this?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all/unable to do
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1-4,R,D) go to COM_2

Instrument Variable Name: COM_SS
Question Text:

Using your usual language, do you have difficulty communicating, for example, understanding or being understood? Would you say no difficulty, some difficulty, a lot of difficulty, or are you unable to do this?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all/unable to do
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1-4,R,D) go to COM_2

Instrument Variable Name: COM_SS
Question Text:

Using your usual language, do you have difficulty communicating, for example, understanding or being understood? Would you say no difficulty, some difficulty, a lot of difficulty, or are you unable to do this?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all/unable to do
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1-4,R,D) go to COM_2

Instrument Variable Name: COM_SS
Question Text:

Using your usual language, do you have difficulty communicating, for example, understanding or being understood? Would you say no difficulty, some difficulty, a lot of difficulty, or are you unable to do this?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all/unable to do
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1-4,R,D) go to COM_2

Instrument Variable Name: COM_SS
QuestionText:

Using your usual language, do you have difficulty communicating, for example understanding or being understood?
Would you say no difficulty, some difficulty, a lot of difficulty, or are you unable to do this?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all/Unable to do
7 Refused
9 Don't know

UniverseText: Sample adults 18+ who were not asked the family disability questions (FDB) and were randomly selected to receive the Quality of Life (QOL) section
SkipInstructions:

(1-4,R,D)[goto COM_1]