P. 1


# OAR Box 1126 Prepped byOllie Stewart



## Document

Number: 

# 53)11-1-17 6 Docket Number: 

# A-83-2 2

Printed 4/18/20089:58:23 AM

Sheet 53 of 182P. 2 

## Th e Universix yo f8irmin<3lTa m •'* * ENVIRONMENT . HEALT H AN D BEHAVIOU R RESEARC H GROU P Sell yWic k

house . 59 . Sell yWic k Road . / Birmingha m . / j 

### B29 7J F 

### T7 Q ' ' Telephon e 021-47 1 235 9 Hea d o fDepartmen t o ( Psychiatry : Professo rIa n Brockingto n Proiec t Director : Pete rHarve y Researc h Associates : Jan e Morga n Ann e Spurgeo n 

### PGH/JMT/6 A 26t hApril , 1983 . . Dr . M . Davies , Maildro p 52 , U.S . Environmenta l Protectio n Agency , Researc hTriangl e Park , Nort hCarolin a 27711 , U.S.A . Dea r Dr . Davies , Followin g ou r telephon e conversatio n I enclos e a copyo f ou r background documen t fo r you r information . I shoul d poin t ou t tha t w e ar e i n th e proces s o f preparin g a pape r fo r publicatio n i n on e o f th e scientifi c journal s an d a s soo n a s thi s i s complet e an d referee d I wil l le t yo u hav e a preprint . I shoul d als o ad

d tha t ther e ar e some dat a missin g fromth e background documen t bu t thes e ar e stil l bein g analysed . I hav e bee n i n touc hwit hsomebod yo n th e Roya l Commissio n an d theyhopefull ywil l b e arrangin g fo r a copyo f thei r repor t o n lead t o b e sen t t o yo u i n th e nea r future . I hav e als o discusse d wit hMarjori e Smit hth e possibilit yo f trying obtai n he r dat a too . A s I believ e yo u kno wther e ma yb e some problem s wit hpresentatio n o f unpublishe d dat a an d I think i t ma ywel l b e bette r fo r yo u t o contac t bot h he r an d Richar d Lansdow

n direc t o n this . I a msorryt o giv e yo u extr a wor k bu t I think i t maywel l b e importan t fc r yo u t o dea l wit hthemo n a persona l basis . I shal l loo k forwar d t o seein g a draf t o f you r ne wdocumen t an d i f I can b e o f an ymor e hel p I shal l b e happyto . Wit hbes t wishes , Your s sincerely ,
P.G . Harve y Projec t Directo r 

# -fe z 

# t r !

• IP. 3

"it . . .—"•''-.- , JJ V ' .-^- r '" a . tt '. A' ' ' • %1 

### .; . ; * * • •!»-_•». • , . • ' , - ( 

### TH E 3 1 ?-

M IN G HA M BLOOD LEA

D STUD Y
PETE R HARVEY , MARK HAMLI N& RA J KUMA R Environment , Healt h& Behaviou r Researc hGroup

Universit yo f Birmingham

Background documen t t o th e pape r "Th e Birmingha m', Bloo d Lea d Stucv " presente d a t th e svmcosium"Lead , : 

### V J an d Healt h- seme psychologica l data " a t th e Annua l >-* ' Conferenc e o f th e Britis hPsychologica l Society , * Universit yO f York , Aori l 1983 . c . „ 

# " 1 ,***•-<•*• £ 1 ***** *TH E BIRMINGHA M BLOO D LEA

D STUDY 1
SUMMARY RESULT S - APRI L 198 3 SAMPL E On e hundre d and eight ynin e (10 4 boys : 8 5 girls ) inner-cit y Birminghamchildren , age d 3 0 month s a t tim e o f testing : bor n i n and remaine d i n Birmingham : sinc e birth : havin g a birthweigh t >2500g : bein g a legitimat e chil d o f a mothe r age d 20-2 9 a t th e tim e o f birth : bein g delivere d i n hospital : and havin g Europea n English
speakin g parents . MEASURE S Parent s i ) Structure d 6 8 itemintervie w(Appendi x I ) coverin g a variet yo f social , healt hand environmenta l factors . ii ) Modifie d Locke-Wallac e Marita l Questionnaire . iii ) Holme s & Rah e Lif e Event s Schedule . vi ) Genera l Healt hQuestionnair e (mother s only) . v ) Raven s Progressiv e Matrice s and Mil l Hil l Vocabular y Scale s (Mother s only ) . • & *Ju V - e >+-v_^*-

m « t ^UsJCt^«-< • Child-Cognitiv e Fou r test s fromBritis hAbilit yScales : ^-r^ . ^^A yev ^

i ) Namin g Ability . * ii ) Recal l o f Digits . iii ) Verba l Comprehension . iv ) Visua l Recognition . Child-Psychomoto r Thre e test s fro mth e Stanford-Binet: .

i ) Shape s - tim e and performance . ii ) Block s - towe r (numbe r o f blocks ) , bridg e (performance )

and time . iii ) Bead s - time and performance . Child-3ehavioura l

i ) Structure d behaviou r ratin g o f vide o tap e o f on e 9 minut e playperio d (wit hmother ) i n a standar d playroo m

(se e Appendi x 2) . ii ) Structure d behaviou r ratin g o f vide o tap e o f complet e tes t perio d (se e Appendi x 2 ) iii ) Teste r rating scal e (se e Appendi x 3 ) iv ) P.I.P . Developmenta l Chart s fille d byparents . Child-Indicato r o f lead burde n On e 2. 5 m l sampl e o f venou s

bloo d take n afte r testing . Analyse d b yDr . T . Delve s (Universit yo f Southampton ) .1 . DAT AANALYSI S GENERA L BACKGROUND 1. 1 Dat. a Codin g an d checking procedures . Th e intervie wdat a wer e categorise d an

d code d durin g th e interview . Th e code d figure s wer e the n transferre d ont o a summaryform , and fromthenc e t o a compute r coding formwhic hwa s use d byth e punc hcar d operators . Asimila r procedur e wa s followe d fo r al l th e othe r data . Al l othe r coding and transfe r wa s carrie d ou t b yon e person . Onc e th e ra wdat a wer e o n a compute r file , a printe d outpu t wa s obtaine d whic hwa s checke d agains t th e origina l form s (no t th e codin g sheets) . Asampl e o f approximatel y1 i n 3 case s wa s use d fo r dat a checking . Ther e wa s on e punchin g erro r and 5 codin g error s i n a tota l o f 2194 8 numbers . Som e dat a fromth e intervie wwa s code d o n a ordere d scal e usuall y wit ha highe r numbe r representin g a highe r freguenc yo f occurrenc e o f th e itembein g measured . Fo r example , questio n 4 1 ask s whethe r th e chil d eve r put s thing s int o hi s o r he r mout htha t aren' t food . Th e mothe r ca n respond no , occasionally , regularl yo r not kr.cwn . Whil e thi s allow s fo r a mor e detaile d quantificatio n o f dat a i t ca n als o lea d t o smal l cel l size s (especiall ywhe n othe r factor s ar e take n int o account) . Furthermore , fo r som e statistica l analyse s thi s dee s no t satisf ymathematica l criteri a suc ha s i s found i n interva l scales . Suc hdat a wer e usuall yrecode d t o formdumm y variables . Wher e thi s ha d bee n done , al l variable s ar e recode d a s dichotomou s variable s ( 0 o r 1) . Agenera l rul e wa s applie d suc hthat , wher e appropriate , suc h categorie s referre d t o th e presenc e o r absenc e o f a phenomenon . Thus , i n th e exampl e give n earlier , 0 woul d cove r .th e n o category an d 1 wcul d cove r bot hoccasionall yand regularly . 1. 2 Stage s o f analysis . Th e statistica l analysi s wa s carrie d ou t i n stages . Th e firs t stag e i s a genera l descriptiv e one , allowing fo r a characterisatio n o f th e sampl e i n term s o f it s social , demographi c and psychologica l characteristics . Thes e dat a ca n b e compare d wit hethe r dat a i n orde r t o chec k o n th e representativenes s o f th e saaple . Th e nex t stag e involve s a n assessmen t o f th e predicto r o r independen t variables ' influenc e o n th e variou s outcom e measures , particularl y I.Q . and othe r psychometri c data . Thes e confoundin g variable s and co-variate s mus t b e adequatel yassesse d prio r t o an yfurthe r analyses . Th e fina l stag e attempt s t o answe r th e centra l questio n o f wha t relationshi p exist s betwee n bloo d lea d and performanc e afte r thos e othe r factor s known t o affec t performanc e ar e take n int o account .

.•sr 1. 3 Procedure s used . Onc e th e dat a wer e punche d ont o card s the y wer e inpu t t o th e IC L 1906 Acompute r a t BirminghamUniversit yand fro mther e transferre d t o th e CD C 760 0 a t th e Univesit yo f Mancheste r Regiona l Compute r Centre . Al l analyse s wer e performe d thereafte r a t Manchester . Th e Statistica l Packag e fo r th e Socia l Science s (Versio n 8 ) wa s use d throughout .Specifically , analyse s o f varianc e wer e use d t o determin e difference s betwee n categorie s withi n variables . Non-parametri c technique s (Spearman rank correlations ) wer e use d i n thes e instance s whe n correlation s wer e neede d a s manyo f th e continuou s variable s wer e non-normall ydistributed . Standar d non-stepwis e regressio n technique s wer e use d i n tw o ways . Firstly , t o determin e wha t predicto r (independent ) variable s significantl y influence d th e outcom e measures . Secondly , whe n significan t predictor s emerge d from th e analyses , a furthe r se t o f regressio n analyse s wer e performe d usin g th e significan t predictor s (non
continuou s variable s code d a s dummies) . Thes e analyse s exclude d bloo d lead . Asecond , identica l analysi s wa s the n carrie d ou t bu t thi s tim e includin g bloo d lea d (a s a continuou s variable) . Th e differenc e betwee n th e su mo f th e square s accounte d fo r b yth e tw o set s o f predictor s wa s calculate d i n orde r t o giv e th e su mo f square s i n th e outcom e variabl e accounte d fo r b ylead ove r and abov e th e othe r predicto r variables . Thi s wa s the n teste d agains t th e residua l mea n squar e fro mth e second regressio n t o giv e a n F ratio , th e significanc e o f whic hwa s assesse d L n th e usua l way . Thes e analyse s wer e repeate d usin g lo g bloo d lea d i n orde r t o tak e accoun t o f an

yske wi n th e distribution . Result s wer e virtuall y identica l whicheve r measur e o f bloo d lea d wa s used . RESULT S Paren t characteristic s - Summarise d i n Table s 1 8 . 2 .

Refusa l rate s - Summarise d i n figur e 1 , Bloo d lead.
- Summarise d i n figure s 2 & 3 . Psychometri c - Cognitiv e Summarise d i n tabl e 3 • '

- Psychomoto r Summarise d i n Tabl e 4 . Bloo d lea d & I Q - Summarise d i n Figure s 4, 5 & 6 . Interralationship s wit hsocia l factor s - Summarise d i n Tabl e 5 . I Q & Test s completed.
- Summarise d i n Tabl e 6 . 

# I

Sunnaryo f regressio n analyses.
- Tabl e 8 .P. 7



### APPENDI X1

### Child' s christia nnam e Dat e of Ir.tervve w 1 . Dat e o f birt h 2 . Age (I nmonths ) 3 . Sex 0 . Mal e

1 . Femal e 4 . Ho w lon g hav e yo ulivedat thi s address ? 5 . Wha t l s you r postcode ? 6 . I t lea s thana year : Wher e di dyoulive before ?

Postcod e An dho w lon g di dyo ulive there ? 7 . 0 . Ow

nHous e 1 . Ow nFla t 2 . Rente dHous e 3 . Rente dFla t 4 . Counci l Hous e 5 . Counci l Fla t 8 . Othe r (specify ) 9 . No t know

n 8 . Ho w ol dis . the hous-e/ilat ? Yea r t--.lt : 0 . Les s than5 year s 1 . 5-1 5 year s 2 . 15-3 5 year s 3 . 35-8 0 year s 4 . Mor e than8 0 year s 9 . No t know

n 9 . I f fla t whic hfloor ? 10 . I s pain t peeling fro m outside walls , woodwork , fixtures , fences , gate s or railings ? 0 . N o 1 . Ye s 9 . No t know

n 11 . I s pain t peeling fro m inside walls , woodwor ko r fixtures ? 0 . N o 1 . Ye s 9 . No t know

n 12 . Ha s housing bee nrenovated ?

0 . Withi n1 2 month s 1 . Befor e 1 2 month s 2 . Stil l being renovated 3 3 . No 9 . No t know

n 

# C E 1 

# CD 

# • C D
1 

# • D I 

# • D 

# •P. 9

"13 . Vlo

w man y childrenar e ther e I nth e house ? 

# . U 14 . Doe s anyone els e liv e here ? 

### 0 . N o 1 . Ye s 

# • 15 . So , th

e numbe r o f peopl e who liv e her e is ? 16 . Ordina l positiono f chil d

position/numbe r o f children 9 . No t know

n 17 . Presen t placemen t o f chil d

0 . Chil dliving wit hbot hnatura l parent s 1/ 2 Chil dlivin

g wit hnatura l mothe r only with/withou t fathe r substitut e 3/ 4 Chil dlivin

g wit hnatura l fathe r onl y with/withou t mothe r substitut e 5 . Chil dlivin

g wit hothe r relativ e 6 . Chil dlivin

g wit hfoste r paren t l n

V.OT r 13 . 19 .

20 .

21 .

22 . 23 . a n institutio n

7 . Adoptio n (circumstances ) 8 . Othe r (specify ) £ R Ag e (yrs. ) Yea r bor a Occupatio n I f no t workin g now , hav e yo u worke d a t al l sinc e ycu r chil d wa s born ? 

### 0 . N o 1 . Ye s Plac e o f Birt h 0 . England , Scotland , Wale s 1 . Irelan d 2 . Europ e 8 . Other s (specify ) Previou s marriag e 

### 0 . No 1 . Ye s Ho wlon g hav e yo u bee n married ? Yea r sarrie d Wha t ag e di d yo uleav e schoo l - an yfurthe r qualifications ? 0 . U p t o schoo l leavin g ag e 1 . Furthe r secondar y 2 . Secretaria l o r technica l qualificatio n 3 . Teache r trainin g 4 . Universit yno t complete d 5 . Degre e 6 . Postgraduat e 8 . Othe r (specify ) 

# • . | |' | 

# q 

# 1 Q 

# • i' i


# • vFATHE R 24 . Ag e (yrs ) Year born 25 . Occupation 26 . Plac e o f Birt h

0 . England , Scotland , Wale s 1 . Irelan

d 2 . Europe 8 . Othe r 

# • 27 . Previou s Marriag e



### 0 . N o 1 . Ye s 

# • 28 . Wha t age di dyo uleav e schoo l - an

y furthe r qualifications ? 0 . U pto schoo l leavin g age 1 . Furthe r secondar y 2 . Secretaria l or technica l qualification s 3 . Teache r trainin g 4 . University

no t completed 5 . Degre e
29 .

30 .

31 .

32 . 8 . Othe r I s chil d currentl yreceivin g medica l attention ? 0 . N o 1 . Ye s I f ye s wha t typ e

Ho wi s his/he r health ? Ha s he/sh e bee n see n b yyou r famil ydocto r recently , i n th e pas t twelv e months ? Ho waaz ytimes ? 0 . Non e 1 . 1 onl y 2 . 1- 5 Exac t nuabe r 3 . Mor e tha n 5 Exac t numbe r 9 . No t known Reason s fo r visit s

Doe s th

e chil dsuffe r fro m headaches , sickness ? 0 . Neve r 1 . Occasionall y 2 . Frequentl y 9 . No t know

n Ha s your chil deve r beena ninpatien t a

t hospital , eve n fo r a night ? (exclude birt hunles s there hadbeencomplications ) 0 . N o 1 . Ye s Reason : Lengt ho f stay : 

# •

~ ]



# • • 9P.1 1



### yer.r , fo r

exampl e stitches , anx-ra y etc ' 0 . None 1 . 1 onl y 2 . 2 onl y 3 . Mor e tha

n2 9 . Not know

n E.g . Burns/scald s Cuts , falls , b^nps , bruise s Fracture s Swallowin

g o r inhalin

g somethin

g Somethin

g u ptt e nose , in th e ear or ia th

e ey e Ca r accident Othe r 

# a

34 . Ha s he/sh

e ha dan y accident s NO T requirin g hospita l treatment ove r th e las t year ? 0 . None 1 . 1 onl y 2 . 2 onl y 3 . 2- 5 4 . Mor e than5 9 . No t know

n 

# •
35 . Ha s your chil deve r sufferedan y type of headinjury ? 0 . Seve r 1 . Minor , no los s o f consciousnes s 2 . Unconciou s les s tha n1 5 minute s 3 . Unconsciou s mor e than1 5 minute s 9 . Not know

n 

# D
36 . Ha s you

r chil dtakenan

y tablet s or medicine s fo r anythin

g :z. ti e pas t year ? Anythin

g fer sleepor appetite , o r to cal

m him/he r i;vn ? lon g for ? Who prescribe dthea ? Hav e the y helped ? Wha t abou t aspirins ? Describe drug s taken , reasonfor takin g the m an deffectivetsss . Ho w

0 . N o drug s taken 1 . Drug 3 usedoccasionall y 2 . Usedfor mor e tha na wee ka

t a tim e durin g th e year 3 . Usedfor mor e thana wee kan dstil l i

nus e 

# •

37 . Aspiri n Medica l Sleep Appetit e Vitamin s Di dyo uhave an

y problem s feeding your chil das a nInfant ? 0 . N o 1 . Ye s 9 . Not know

n I f yes , wha t typ

e o f :rcolem

? 

# •

S iP.1 2

' 38 .



### 39 .

40 .

41 .

42 . U o yo ufee l tha t anythin g i nyou r child' s healt ho r behaviou r i s a problem ? 

### 0 . N o 1 . Ye s Reason :
D o yo uhav e an y

Ide a o f th e caus e o f this ?

D o yo uthin kyou r chil dha s a larg e appetite , i s he/sh e a goo deater ? O r l s he/sh e goin g throug hth e fadd y stage ? Doe s he/sh e ge t fuss y abou t his/he r food ? D o yo ueve r hav e t o mak e specia l meals ? 0 . N o eatin g difficultie s 1 . Som e eating difficultie s (Hs s som e fads , o r poo r appetite ) 2 . Marke ddifficultie s (Poo r appetit e an drefusa l t o ea t al l bu t a fe w items ) Doe s you r chil dsuc khis/he r thumb ? 0 . N o 1 . Ye s Doe s you r chil deve r pu t thing s tha t aren' t foo dint o his/he r mouth ? 

### 0 . N o 1 . Occasionall y 2 . Regularl y 9 . No t know n Peelin g ol dPain t Fres hpain t Ous t o r dir t Paae r Pencil s Other s (specify )

Doe s you r chil dhav e an y slee pproblems ? 

# •

• • •

0 . No 1 . Occasionall y 2 . Regularl y Abilit y t o fal l asleep good/bad Restles s sleep Nightmare s Doesn' t slee pthroug h the nightP.1 3

43 . Doe s you r chil dhav e his/he r ow nbedroom ?

44 .

45 .

46 . Ho w for fo r 0 . 1 . 2 . 3 . 4 . 5 . 6 . 7 . Sleep s alone/ow nroo m Sleep s wit hparents/ow nbe d Sleep s wit hparents/parent s be d Sleep s wit hslbs/ow nbe d Sleep s wit hsibs/share s be d Share s be dwit hsib s l nparent s roo m An y othe r sleepin g arrangements/ow nbe d An y othe r sleepin g arrangements/share s be d activ e i s you r child ? Doe s he/sh e no t lik e sittin g stil l eve n me a Ls ? Ho w

man y minute s wil l he/sh e si t usually ? Wha t abou t a stor y

...T.V. ? Ho w

lon g ha s he/sh e bee nlik e this ? 0 . 1 . 2 . 3 .
I s you r No t markedl y activ e Ver y activ e Hyperactive , sit s stil l fo r meal s o r o nothe r occasion s usuall y

les s tha n5 minute s Underactive : spend s mos t o f th e tim e stationar y an d unoccupie d(apar t fro m habits ) chil drestles s whe nyo utak e him/he r shopping ? Doe s he/sh e rus haroun dan dtouc heverything ? 0 . 1 . 2 . N o Occasionall y Regularl y Wher e doe s you r chil dmos t lik e t o spen dhis/he r tine . Insid e o r outsid e 0 . 1 . 2 . I f 1 . 2 . 3 . 9 . th e house ? Insid e th e hous e Outsid e th e hous e Spli t equall y

betwee nth e tw o outside : Garde n Stree t Playgroun d No t know n 

# • ; 1 

# P P j \ 

# a 4 7 . Ha s you r chil dplaye di nan y o f thes e place s i nth e pas t month ? Corridor , balcon y o r stair s Concret e are a aroun destat e I nstree t I npar k Children' s o r adventur e playgroun d I nsomeon e else' s hous e I nsomeon e else' s garde n Elsewher e (omi t playgroup ) 4 8 . Wha t l s th e longes t he/sh e wil l stic kt o on e thin g Indoor s i f he/sh e l s Interested ? 0 . Concentrate s usuall y fo r mor e tha nfiftee nminute s 1 . Concentrate s usuall y fo r 5-1 5 minute s 2 . Concentrate s usuall y neve r mor e tha na few minute s 

# g49 . Doe s he/she eve r hav e temper tantrums ? Wha t happens ? I s i t a rea l tantru m wit hscreaming , banging , shouting , kicking ? Ho w lon g d o t.-.e y last ? 0 . N

o tantrum

s 1 . Brie f tantrum

s lastin

g a fe w minute s 2 . Frequen t tantrums lastin g mor e tha

nfiftee

nminute s Frequenc y

pe r wee k 5 0 Doe s he/she go to a nurser y or playgroup , or anywher e els e regularly ? 0 . Neve r attended 1 . Schoo l 2 . Attend s playgou p 3 . Da y nurser y 4 . Dail y

minde r 5 . Ha s attendedplaygrou po r schoo l inpas t 8 . Othe r Frequency : No . o f session s pe r week

(on e session= Ja day ) (I f les s tha

n1 tent hput 1 ) 51 . Doe s you r chil dnav e a set bedtime ? 0 . Ye s 1 . No 52 . Ha s your chil dbee nimmunised ? 0 . Ye s 1 . N o 53 . Ar e ther e particula r thing s that yo uenjo y doin g as a family wit hyour child ?

54 . Do you(mother ) c r your husban

dhav e an y hobbies ? Wine o r bee r making , enamelling , or potter y fo r instance ? Mothe r Fathe r 0 . N o 0 . N o 1 . Ye s 1 . Ye s I f ye s wha t ar e they ? 5 5 Do youhave a car ?

0 . N o 1 . Ye s 

# a
• a
• • a

•- r r ..a. :

Child' s christia nnam e SAMPL ENUMBE R RESEARCH NUMBE

R Dat e o f Intervie w -P.1 5

Wa s chil d delivere d i n hospital ? 0 . Ye s 1 . N o I f no , why ? Which hospital : Consultant : Wha ti s you rGenera l Practitioner' s nam e and address ? 

# •

2 . Wa s chil d bor n o n dat e he/sh e wa s due ?

0 . O n tim e 1 . Up t o tw o week s earl y 2 . Mor e tha n ra o week s earl y 3 . Up t o tw o week s lat e 4 . Mor e tha n TT O week s lat e 9 . No t know n 

# U Wha t di d you r

chil d-veigh ? 0 . 8-lOlb s 1 . 6i-81b s 2 . 5-6Uh s 3 . 3-51b s 4 . Les s tha n 3 lb s 5 . Mor e tha n 10lb s 9 . No t know n 4 . Wher e ther e an

ycomplication s o f birt ho r delivery ' 0 . N o 1 . Ye s 9 . No t know n Caesaria n sectio n Emergenc y Planne d Breec h Forcep s Anxiet yove r breathin g Jaundic e Othe r 5 . Wa s an

yspecia l car e give n t o th e baby , di d yo u bot hg o hom e togethe r o r di d th e babyhave t o stayl n hospita l fo r an yreason ? 0 . Car e no t give n 1 . Car e give n 9 . No t know n I f car e given , reason : 

# u

nP.1 6 fcorfollowin g7 questions : 0 . Noraa l 1 . Slo w 2 . Fas t 9 . No tIciawn 6 . A t wha t age di dyour chil dfirs t fee dhimself/hersel f wit ha spocn ? (13-2 4 ssaths ) month s

7 . A t wha t age di dyour chil dfirs t si t alone ? (5- 9 months ) month s 8. . Whendi dyou

r chil dsa

y his/he r firs t words ? (13-2 1 mnnths ) month s
9 . An dwhendi dhe/sh

e sa y his/he r firs t sentences ? (18-2 7 mznths ) month s
10 . An dwha t abou

t toile t training ? Whe nwa s he/s^ e dr y during th

e dny ? Bladde r ;iay ) (1- 5 years ) year s
11 . Whe nwa s he/sz a dr y during th

e night ? Bladde r Ctight ) (1- 5 years ) year s
12 . An dwhenwa s he/she clean , bowe l trained ? Bowel s di- 5 years ) year s
13 . I s hai r dy

e of an y sor t usedinyour household ? 0 . No 1 . Ye s I f yes , wha t type ? 

# •I

• • • • • D 

# •

### APPENDIX2 P.1 7P.1 8

BEHAVIOUR S CODE D I NPLAYROO M

CATEGOR

Y COD E BEHAVIOUR S

MOVEMEN T N

M No movemen t W A Walking , running , hopping , jumpin g CRCrawlin

g CL Climbin go nclimbin gfram e S L Slidin go nslid e af TMov eo ntruc k

.AR M MOVE2CN

T N

A Neutra l arm s F L Flap , beat , cla p P O Poin t H F Han

dt o fac e A M Automanipulat e TM Touchmothe r

POSTURE U R S D S Q K N B N A F Upright

Si t dow n Squa t O nknee s Ben dove r O nfloor o

nhand s an

dknee s or stomach



### (se e over ]BEHAVIOUR S CODE D I N TES T SITUATIO N P.1 9

CATEGORY COD E BEHAVIOUR S
LOOKIN G EX

T S A W Lookin

g a t experimente r Looking a

t tes t materia l Looking awa

y an dno t a

t eithe r experimente r o r tes t materia l

VOCA L NS

V O C R P N N

o soun d I Talking or vocalizationothe r tha nthos e listedbelo w
, Cryin g Pla y nois e o r laug

h

MOVEMEN T N

B B M H M T C T T LO L T W A N

o bod y movemen t Bod y movement Headmovemen t I ntes t chai r a

t tes t tabl e Ou t o f tes t chai r a t tes t tabl e Lif t out o f tes t chai r La y o ntes t tabl e Wal kawa

y fro m tes t tabl e

AR M MOVEMENT N

UNeutra l arm s P N Poin t A UAutomanipulat e H M Han

dt o fac eP.2 0



### APPENDI X33EKAV::-J R AII D ATTITUD E CHECKLIS T
NA I IE : AGE : TES T ADMINISTERED : Instructions : Plac e a n " "X " o n EXAMINER : DAT E O F REPORT : DAT E O F EXAMINATION : th e appropriat e lin e fo r eac hscal e
I . Attitud e toward s examiner :

1 . passiv e 2 . hostil e II . Attitud e towar d test , situat ;

3 . tens e 4 . intereste d 5 . eage r 6 . enjoyabl e 7 . trie s hi s best : 8 . give s u p o nhar diterz s 9 . interes t

leve l continuousl yhig h III . Attitud e toward s self : 10 . confiden t 1 1 boastfu l IV . Work , habit s 12 . fas t 13 . answer s deliberatel y 14 . think s alou d 15 . careles s V . Reactio nt o tes t iteas : 16 . understand s direction s

easil y cn : aggressiv e friendl y ! relaxe d !
i uninivolve d! perfunctor y no t enjoyabl e ' doe s no t tr yhi s bes t , doe s no t giv e u p o n har d it=^ s i I interes t

leve l variabl e ,



# i i no t confiden t self-derogator y slo w answer s inpulsivei y think s silentl y nea t

understand s instruction s wit h difficult yP.2 2

13 . exa.-nir.e

r 5' 5 tjuestion s : : : : : : : examiner' s question s d o hel p exaaine e expres s no t hel p examine e idea s expres s idea s
VI . Reactio n t o failure : 19 . awar e o f failur e : : : : : : : obliviou s o f failur e 20 . cal m: : : : : : : agitate d 21 . apologeti c : : : : : : : no t apologeti c 22 . work s harde r afte r : : : : : : : give s u p easil yafte r failur e ' failur e
VII . Reactio n t o praise : 23 . accept s gracefull y: : : : : : : accept s awkwardl y 24 . work s harde r afte r : : : : : : : retreat s afte r prais e prais e
VIII . Language : 25 . fluen t : : : : : : : haltin g 26 . articulat e : : : : : : : inarticulat e 27 . response s direc t : : : : : : : response s vagu e 28 . converse s spontaneousl y: : : : : : : onl yspeak s whe n spoke n t o 29 . bizarr e : : : : : : : realit yorientate d 30 . error s indicat e :::::: : error s indicat e

am —^ ^' "a- " ' • — •TM"aa —" I I '^ ^^^ ^ association s easil yassociation s no t easil y recognizabl e recognizabl e IX . Visual-soto r 31 . reactio n tim e slo w: : : : : : : reactio n tim e fas t 32 . trial-and-erro r : : : : : : : carefu l an d planne d 33 . skillfu l movement s : : : : : : : awkwar d movement s 34 . relevan t gesture s : : : : : : : irrelevan t gesture s 35 . overcontrolle d : : : : : : : impulsiv e
X . Overal l tes t results : 36 . vali d : : : : : : : invali d 37 . reliabl e : : : : : : : unreliabl e XI . Other :

### APPENDIX23EHAVI0UR S CODE DI N PLAYROO

M

CATEGOR Y COD E BEHAVIOUR S

MOVEMENT N M No movemen t W A Walking , running , hopping , jumpin g CRCrawling C L Climbin

g o nclimbing fram

e 'S L Sliding o

nslide H r Mov

e ontruc k

AR M MOVEMENT

POSTUR E N A Neutra l arm s FL Flap , beat , clap P O Poin t HF Han

dto fac e A M Automanipulat e TM Touchmothe r U R SD S Q K N B N A F Upright

Si t dow n Squa t O nknee s Ben dove r Onfloor onhand s an dknee s or stomach



### (se e over )SEHAVIOUR S CODED I N TES T SITUATIO N P.2 5

CATEGOR

Y CODE BEHAVIOUR S
LOOKIN G E X

T S A W Lookin

g a t experimente r Looking a

t tes t materia l Looking awa

y an dno t a

t eithe r experimente r o r tes t materia l

VOCA L N S

V O C R P N N

o soun d Talking or vocalizationothe r tha nthos e listedbelo w Cryin g Pla y nois e o r laug

h

MOVEMENT N B No bod

y movemen t BM Bod

y movemen t H M Headmovemen t T C I

ntes t chai r a

t tes t tabl e T T Ou t o f tes t chai r a t tes t tabl e LO Lif t ou t o f tes t chai r L T La

y o ntes t tabl e W A Wal kawa

y fro m tes t tabl e

AR M MOVEMEN

T N

UNeutra l arm s P N Poin t A UAutomanipulat e H M Han

dt o fac eP.2 6



### APPENDI X3

## -yr- 1 P.2 7

3EHAVICUR '-ZZ

ATTITUD E CHECKLIS T
NAItE : EXAMINER : AGE : DAT E O F REPORT : TES T ADMINISTERED : DAT E O F EXAMINATION : Instructions : Plac e a n " "X " o n th e appropriat e lin e fo r eac hscal e
I . Attitud e toward s exaniner : 1 . passiv e ' : : _: : : : : aggressiv e 2 . hostil e : : _: : : : : friendl y II . Attitud e towar d tes t situation :

3 . tens e : : : : • : : : relaxe d 4 . intereste d : : : : : : : uninivolve d 5 . eage r : : j: : : : perfunctor y 6 . enjoyabl e : : : : : : : no t enjoyabl e 7 . trie s hi s best . : : : : : : : doe s no t tr yhi s bes t 8 . give s up o n hai d i-er s : : _ : : : : : doe s no t giv e up o n har d iter s 9 . interes t leve l continuousl yhig h: : : : : : : interes t leve l variabl e III . Attitud e toward s self : 10 . confiden t : : _ : : : : : no t confiden t i 1 1 boastfu l : : •».; • : : : : self-dercgator y IV . Wor k habit s 12 . fas t : : : : : : : slo w 13 . answer s deliberatel y: ; : : : : : answer s impulsivel y 14 . think s alou d : : _ : : : : : think s silentl y 15 . careles s : : : : : : : nea t V . Reactio n t o tes t items : 16 . understand s direction s

easil y: : : : : : : understand s instruction s wit h difficult yJi;;-.:'-- i ?- -• » 13 . examiners' s question s : : : : : : : examiner' s question s d o hel p examine e expres s no t hel p examine e idea s expres s idea s
VI . Reactio n t o failure : 19 . awar e o f failur e : : : : : : : obliviou s o f failur e 20 . cal m: : : : : : : agitate d 21 . apologeti c : : : :__ j : : no t apologeti c 22 . work s harde r afte r . : : : : : : : give s up easil yafte r failur e failur e VII . Reactio n t o praise : 23 . accept s gracefull y: : - . : : : : accept s awkwardl y 24 . work s harde r afte r : : : : : : : retreat s afte r prais e prais e VIII . Language : 25 . fluen t : : : : : : : haltin g 26 . articulat e : : : : : : : inarticulat e 27 . response s direc t : : - . : : : : response s vagu e 28 . converse s spontaneousl y: : : : : : : onl yspeak s whe n spoke n t o 29 . bizarr e : : : : : : : realit yorientate d 30 . error s indicat e : : : : : : : error s indicat e association s easil yassociation s no t easil y recognizabl e recognizabl e 

### IX . Visual-moto r 31 . reactio n tim e slo w: : : : : : : reactio n tim e fas t 32 . trial-and-erro r : : : : : : : carefu l an d planne d 33 . skillfu l movement s : : : : : : : awkwar d movement s 34 . relevan t gesture s : : : : : : : irrelevan t gesture s 35 . overcontrolle d : : : : : : : impulsiv e
X . Overal l tes t results : 36 . vali d : : : : : : : invali d 37 . reliabl e : : : : : : : unreliabl e XI . Other :P.2 9

FIGURE S

# SUBJEC T AVAILABILIT Y

AVAILABILIT Y REFUSAL RAT E

NO T AYAILAH E 4S.6 X NO T SEE N REFUSE D 14.2 X

AVAIUH E 54.3 X SEE N44.3 X FIGUR E1



# uP.3 1



# BLOO D LEA D
EQJ " no p IFa nLEVEL S

sp _ 4. 2 

### u/d l 0.2 0 u-o l



## 1 0 1-1 1-

2 1* 3 

## 1 *
FIGUR E2•aa'r-^rrJT^r^nT

c s



## L U C D L U CO 

## Z D C D OS 

### U J 

## C D C D C D Q QFIC.U1U- : 4 

## 12 6
I Q 11 4

10 2



## 9 0

78 -



## 66 -• 3 6 Bloo d lea d & I Q Overal l

r s -0-17 * Y " 104-42 -0-45 X

••••

•••

i i 

### • 5 1 0 •

7 1 4 •

9 1 8 1 1

2 2 1 3

2 6 1-

5 3 0 /itno l Mg/d l 

### BLOO D LEA D

### 90 }

80 1 P.3 4



### Bloo d lea d & I Q No n Manua l 120| - 

### I Q 110 |

100 1 r = 00 6 Y = 100-68-0-12 X

•9



### 701 - 

### 6 •5

1 0 •

7 1 4 

### •

9 1 8
FIGUR E 5 

### 1 1 1- 3 2 2 2 6 BLOO D LEA D 

### 1- 5 

### 3 0 M 

### mo l M 9 

### d l"TT" " P.3 5



### Bloo d lea d & I Q Manua l
120 - r « -0-32* * ! Y « 108-3

2 - 0-78 X 

## IQ 11 0

10 0



## 90

80

7 0 • 3 ••

J L J
_ 

### x • 5 1 0 •

7 1 4 

## •

9 1 8 1-

1 2 2 1-

3 2 6 BLOO D LEA D 1- 5 MfT«O l 3 0 Mg/d l

FIGUR E6P.3 6



### :.-3LE S

### PARENT VARIABLE S - FATHE R

SOCIA L CLAS S I I I II I N M II I M IV V UNEMPLOYE D MISSIN G NON-MANUA L MANUA L MISSING/UNEMPLOYE D N

~ 5 2 2 1 4 8 4 2 9 6 2 6 3 4 1 11 9 2 9 % 

### 3

1 2 8 4 5 1 6 3 1 4 — 

### 2 2 6 3 1 5
EDUCATION N U P T O SCHOO L LEAVING AG E FURTHE R SECONDARY TECHNICA L TEACHE R TRAININ G UNIVERSIT Y - INCOMPLET E UNIVERSIT Y - UNDERGRADUAT E UNIVERSIT Y - POS T GRADUAT E MISSING UP T O SCHOOL-LEAVING AG E FURTHE R EDUCATIO N 15 0 1 1 1 8 1 1 3 3 2 15 0 3 7 8 0

6 1 0 1 1 2 2
— 

### 8 0 2 0
PLAC E O F 3IRT H N % 

### U K MAINLAN D EIR E OTHER/MISSING 17 2 1 5 2 9 2

8

AG E MEA N S.D . MOD E RANG E 30. 0 4. 6 2 9 22-4 8

TABL E 1 (Tabl e 2 over )

### OCCUPATION PARENT VARIABLE S - MOTHE R P.3 8



### FULL-TIM E PAI D WOR K PART-TIM E PAI D WOR K HOUSEWIF E PAI D WOR K HOUSEWIF E 4 3 2 7 1 9 7 0 1 9 2 3

1 4 6 3 3 7 6 3
EDUCATION N

PLAC E O F 3IRT H U P T O SCHOOL-LEAVING AG E FURTHE R SECONDAR Y SECRETARIAL/TECHNICA L TEACHE R TRAINING UNIVERSIT Y - UNDERGRADUAT E UNIVERSITY - POS T GRADUAT E
U K MAINLAND EIR E OTHE R 4 7 1 6 1 3 7 4 2 N 5 6 2 1 2 7 8

8 7 4 2 1 % 

### 8 8 1 1 1
AG E MEA N S.D . 27. 2 2. 6 MOD E RANG I 2 5 20-3 4
GH Q SCOR E MEA N S.D . (LIKZR T SCORING ) MOD E

RANG E MEA N S.D . MOD E RANG E 41. 4 22. 1 32. 0 12-15 0 7. 2 10. 3 0 0-5 0
NUMBE R SCORING < 1 1 NUMBE R SCORING > 1 2 ( 2 MISSING CASES ) 14 5 4 2

TABL E 2PSYCHOMETRI C TEST S - SUMMAR Y RESULT S BRITIS H ABILIT Y SCALE S
ABILIT Y SCORE S
NAMIN G RECAL L COMPREHENSIO N RECOGNITIO N 

## i.e . N
15 2 7 3 11. 4 I. l J 13 1 MEA N

44. 7 43. 4 1.3. 9 I I .( » 97 . 'J S D

12. 9 15. 1 il.'., 14. U 11. J MOD E

5 5 2 9 H 7 V.l 10 4 MEDIA

N
46. 8 42. 0 hi, A) 29.« . yy. o RANG E

10-6 4 29-7 5 IO-I1 7 |o-/ w OO-11' J POTENTIA L

RANG E 10-6 4 29-18 9 H i --M7 |ij..|»' » '.i l - I'l' J
SCORE S NAMIN G RECAL L COMPREHENSION RECOGNITION MEA N 15 2 7 3 15 9 13 1 13 1 45. 1

53. 9 45. 9 50. 9 50. 7 7. 9

5. 1 9. 1 6. 6 4. 1 5 2

4 9 5 9 4 9 53. 8 46. 5

54. 4 46. 1 49. 9 50. 6 27-5 8

47-6 4 27-5 9 41-6 9 42-58. 8 27-9 9

27-9 9 27-9 9 27-9 9 27- 7 3



### TABL E 3 (Tabl e 4 over )PSYCHOMETRI C TEST S SUMMARY RESULT S

SHAPE S BLOCK S READ S BRIDG E N 17 2 17 2 16 9 16 9 STANFORD -

% PASSING 85. 7 8 1 . O 55. 6 21. 2 -BINE T TEST S

MEA N 13. 6 30. 1 62. 3

- TIME S (

S.D . 11. 5 15. 9 21. 8

- sec ) MOD E

8. 0 20. 0 40. 0

- MEDIA

N lO. O 26. 8 57. 8

- RANGE

5.8 9 7-8 5 27-11 6

-



### TABL E 4

O• , 4 ii

INDEPENDENTVARIABLE S SHOWIN G

HOUSIN G PAREN T- FATHE

R

PAREN T- MOTHE

R

CHIL D - GENERA

L

HEALTH

BEHAVIOUR RELATIONSHI PWIT H IVTCOM

E

Hous e Ag e Insid e Peelin g Pain t Ag e Socia l Clas s Educationa l Leve l Lif e Event s Marita l Satisfactio n Ag e Workin g Educationa l Leve l GH Q Lif e Event s Marita l Satisfactio n Se x Ordina l Positio n Grou p Attende r Visit s t o Dcoto r Medicatio n Inpatien t Majo r Accident s Mino r Accident s Hea d Injur y Nonfoo d Mouthin g Dus tEatin g Thu mSuckin g Dumm y Use r Activit y Leve l Activit y Ou t Proble mBehaviou r Concentratio n Tantru mTyp e Tantru mFrequenc y Slee p Problem s ASIGNIFICAN T VARIABLE SI.Q.NAMING

+ +

•+• •*•

+ + + +

+ • +

+

•> •>

• +RECALL

+

•>COMP.RECOG.

+

•

+

+

+

+

+

+

+

•SHAPES

•

+

->BLOCKS

•+ •

+ a a < 

## a

• P.4 1

. ] . ,

1+BLOODLEAD

• * .

1NUMBE RO F TEST S COMPLETE

D P.4 2

B.A.S . ABILIT Y SCORE S NAMIN G RECAL L COMPREHENSIO N RECOGNITIO N I.Q . B.A.S . T-SCORE S NAMIN G RECAL L COMPREHENSIO N RECOGNITIO N MEA N STANFOR D BINE T SHAPE S - TIM E (sec )

- % PASSIN G BLOCK S - TIK E (sec )

- % PASSIN G TOWE R - MODA L HEIGH T BRIDG E - % PASSIN G BEAD S - TIM E (sec )

- % PASSIN G 1

•aa" * 49. 2 43. 5 * . • » * " — 21. 5 4". 6 53. 9 43. 4 51. 3 50. ' 12. 0 9 ~ :?. 5 9 6 6 3]_ 59. 0 6- i 3

49. 4 42. 6 65. 0 29. 6 93. 5
44. 4 53. 6 45. 6 50. 0 47. 3
11. 6 9 9 31. 0 9 1 6 • 2 2 64. 2 7 0 < 3

34. 5

- 45. 7 29. 7 "
39. 2

- 37. 9 50. 0

• a " 21. 0 8 2 34. 0 7 4 0 1 1 66. 4 4 6 P

•»» »

** * N S ** * N S N S



### 5 3 6 7 5 4

MEA N TES T SCORES 3 Y JTJXSE R0 ? 3.A.S . TES T COMPLETE D



### TA3L E6. ' •

SUMMAR Y O F ? RATIO

S COMPARIN

G REGRESSIO

N ANALYSI S *IT H AN

D WITHOU

T BLOO D LEA D

Namin g Recal l Comprehensio n Recognitio n I.Q . Shape s Block s Bead s F < 1 1.2 6 < 1 < 1 < 1 < 1 2.3 4 2.4 6 d.f .

1,7 6 1 . 6 3 1,10 6 1,7 3 1.7 1 1,12 2 1,12 9 1,9 3 P

NS NS NS NS NS N S NS NS

TABL E 8