Protocol - Pediatric School Performance
This protocol includes four questions from the Education - School Questionnaire from the Pediatric Hydroxyurea Phase III Clinical Trial (BABY HUG). The four questions capture the child’s current grade and age, whether the child has ever been held back, and if so how many and which grades, and whether the child receives special accommodations for education.
The Sickle Cell Disease Research and Scientific Panel (SRSP) notes that this measure can be supplemented with the Day Care Attendance protocol in the Toolkit.
Although this measure has been validated for use in ages 24 months to 21 years, it is most practical in pediatric populations.
The SRSP recommends that investigators ask parents to bring in a copy of the childs report card to verify the number of days missed from school.
BABY HUG Part VII: EDUCATION - SCHOOL QUESTIONNAIRE
1. What is your child’s current grade? __________
2. What is your child’s current age? ________ years __________months
3. Has your child ever been held back or repeated a grade?
A. How many grades?
[ ] 1
[ ] 2
[ ] 3 or more
B. Which grade(s)? (List up to 3 most recent grades) ______ ______ ______
4. Does your child have any accommodations because of learning differences? Check all that apply:
[ ] A. Special Education Services
[ ] B. 504 plan
[ ] C. IEP-individualized education plan
[ ] D. Special tutoring or classes not available to regular students
[ ] E. Other
1. Describe: ______________________
[ ] F. My child does not receive any accommodation for learning differences
Personnel and Training Required
|Specialized requirements for biospecimen collection||No|
|Average time of greater than 15 minutes in an unaffected individual||No|
Mode of Administration
Toddler, Child, Adolescent
Children and adolescents, ages 24 months to 18 years
Several questionnaires were considered, but the questionnaire from the Pediatric Hydroxyurea Phase III Clinical Trial (BABY HUG) was selected because it was used in a major sickle cell disease clinical trial, captures which grades were repeated, and includes multiple education accommodations.
|caDSR Common Data Elements (CDE)||Pediatric School Performance Questionnaire Assessment Text||4924422||CDE Browser|
Process and Review
Protocol Name from Source
Pediatric Hydroxyurea, Phase III Clinical Trial (BABY HUG), Part VII: Education - School Questionnaire
U.S. Department of Health and Human Services. National Institutes of Health. National Institutes of Health. National Heart, Lung, and Blood Institute (NHLBI). Pediatric Hydroxyurea Phase III Clinical Trial (BABY HUG). Part VII: Education - School Questionnaire. Questions 1-4.
Thompson BW, Rogers ZR, Miller ST, Rees RC, Ware RE, Waclawiw MA, Iyer RV, Casella JF, Luchtman-Jones L, Rana S, Thornburg CD, Kalpatthi RV, Barredo JC, Brown RC, Sarnaik S, Howard TH, Luck L, & Wang WC. (2010). The Pediatric Hydroxyurea Phase III Clinical Trial (BABY HUG): Challenges of Study Design. Pediatric Blood & Cancer 5, 250-255.
Lebensburger JD, Miller ST, Howard TH, Casella JF, Brown RC, Lu M, Iyer RV, Sarnaik S, Rogers ZR, & Wang WC. (2011). Influence of severity of anemia on clinical findings in infants with sickle cell anemia: Analyses from the BABY HUG study. Pediatric Blood & Cancer 59, 675-678.
Armstrong FD, Elkin D, Brown R, Glass P, Rana S, Casella J, Kalpatthi R, Pavlakis S, Mi Z, & Wang W. (2013). Developmental function in toddlers with sickle cell anemia: A report from the BABY HUG Trial. Pediatrics 131(2), e406-14.
|Variable Name||Variable ID||Variable Description||dbGaP Mapping|
|PX840201020000||What is your child's current age?||N/A|
|PX840201010000||What is your child's current grade?||N/A|
|PX840201040100||Does your child have any accommodations more||N/A|
|PX840201040200||Does your child have any accommodations more||N/A|
|PX840201030100||Has your child ever been held back or more||N/A|
|PX840201030200||How many grades?||N/A|
|PX840201030300||Which grade(s)? (List up to 3 most recent grades)||N/A|
|PX840201030400||Which grade(s)? (List up to 3 most recent grades)||N/A|
|PX840201030500||Which grade(s)? (List up to 3 most recent grades)||N/A|
Pediatric School Performance
July 30, 2015
A questionnaire to assess educational performance and learning accommodations.
Many rare genetic conditions (e.g., sickle cell disease) and other diseases are associated with developmental delays, damage to the central nervous system, and frequent absences from school due to illness, all of which can impact school performance.
Sickle cell disease, SCD, demographics, education, educational attainment, school, college, socioeconomic status, economic status, social status, student, Pediatric Hydroxyurea Phase III Clinical Trial, BABY HUG, learning disability, intelligence, developmental delay
|Protocol ID||Protocol Name|
|840201||Pediatric School Performance|
There are no publications listed for this protocol.