CDEs
Forms
How sure are you that you can do something to cut down on most of the pain?
How sure are you that you can keep doing most of the things you do day-to-day?
How sure are you that you can keep sickle cell disease pain from interfering with your sleep?
How sure are you that you can reduce your sickle cell disease pain by using methods other than taking medications?
How sure are you that you can control how often or when you get tired?
How sure are you that you can do something to help yourself feel better if you are feeling sad or blue?
As compared with other people with sickle cell disease, how sure are you that you can manage your life from day-to-day?
How sure are you that you can manage your sickle cell disease symptoms so that you can do the things you enjoy doing?
How sure are you that you can deal with the frustration of having sickle cell disease?
Has your child recovered completely from the stroke?
Does your child have any problems with strength, coordination, or sensation including vision or hearing, as a result of the stroke?
Please choose which of the following are present in your child
Other problems with strength or coordination; describe
Does the problem affect your child’s day-to-day activities?
Right side face or body
Left side face or body
Does your child have difficulty expressing him/herself verbally? (Exclude dysarthrias or pronunciation problems)
Please describe
Does your child have difficulty understanding what is said to her/him?
Please describe
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142