Table 1: Selected questions from the CCHAPS survey1.

QuestionPossible responses

In general how would you describe this child’s health?Excellent; very good; good; fair; poor
Approximately how tall is this child?Inches or centimeters
Approximately how much does this child currently weigh?Pounds or kilograms
Please indicate whether a doctor or health care professional has ever told you that the child you selected (for this survey) has any of the following conditions: asthma, hay fever, skin rash or allergy, three or more ear infections, otitis media (inflammation of the middle ear), ear tubes, and tonsillectomy (had his/her tonsils removed). Yes/no/don’t know
In your opinion does the child have any behavioral, emotional, or developmental problems outside of what you would consider typical for a child his or her age?Yes/no
Has this child ever done any of the following? Had sleep problems.Yes/no/don’t know
Please indicate how often the following items occur: people smoke cigarettes in your home. Daily, weekly, monthly, a few times a year, seldom or never, don’t know
How many times did this child visit the emergency room during the past 12 months?———times
How many days did this child spend in the hospital in the past 12 months?———days
What is the primary language spoken in your household?Spanish; English; other
Has this child ever done any of the following: had academic problems at school; had behavior problems at school?Yes/no/don’t know
Approximately how many days of school did this child miss last year due to health problems?———days

1Presented items are those most likely to require clarification. Wording of other items may be obtained from the authors on request.