| Name | Label | Question | 
| CAGE_11 | 
        Age
       |  | 
 | 
| DA2 | 
        Compared to other children, does have any serious delay in
       | 
          COMPARED TO OTHER CHILDREN, DOES (name) HAVE ANY SERIOUS DELAY IN SITTING, STANDING OR WALKING?
         | 
 | 
| DA3 | 
        Compared to other children, does have difficulty seeing,
       | 
          COMPARED TO OTHER CHILDREN, DOES (name) HAVE DIFFICULTY SEEING, EITHER IN THE DAYTIME OR AT NIGHT?
         | 
 | 
| DA4 | 
        Does appear to have any difficulty hearing or does he/ she
       | 
          DOES (name) APPEAR TO HAVE ANY DIFFICULTY HEARING OR DOES HE/ SHE USE HEARING AID OR IS HE/ SHE COMPLETELY DEAF?
         | 
 | 
| DA5 | 
        When you tell to do something, does he/ she seem to understa
       | 
          WHEN YOU TELL (name) TO DO SOMETHING, DOES HE/ SHE SEEM TO UNDERSTAND WHAT YOU ARE SAYING?
         | 
 | 
| DA6 | 
        Does have difficulty walking or moving his/ her arms or does
       | 
          DOES (name) HAVE DIFFICULTY WALKING OR MOVING HIS/ HER ARMS OR DOES HE/ SHE HAVE WEAKNESS AND/ OR STIFFNESS IN THE ARMS OR LEGS?
         | 
 | 
| DA7 | 
        Does sometimes have fits, become rigid or lose consciousness
       | 
          DOES (name) SOMETIMES HAVE FITS, BECOME RIGID OR LOSE CONSCIOUSNESS?
         | 
 | 
| DA8 | 
        Does learn to do things like other children of his/ her age
       | 
          DOES (name) LEARN TO DO THINGS LIKE OTHER CHILDREN OF HIS/ HER AGE?
         | 
 | 
| DA9 | 
        Can make himself/ herself understood in words
       | 
          CAN (name) MAKE HIMSELF/ HERSELF UNDERSTOOD IN WORDS?
         | 
 | 
| DA11 | 
        Is speech not clear enough to be understood by people other
       | 
          IS (name)’S SPEECH NOT CLEAR ENOUGH TO BE UNDERSTOOD BY PEOPLE OTHER THAN THE IMMEDIATE FAMILY?
         | 
 | 
| DA12 | 
        Can name at least one object such as an animal, a toy, a cup
       | 
          CAN (name) NAME AT LEAST ONE OBJECT SUCH AS AN ANIMAL, A TOY, A CUP, A SPOON, ETC.?
         | 
 | 
| DA13 | 
        Compared to other children of the same age, does appear in
       | 
          COMPARED TO OTHER CHILDREN OF THE SAME AGE, DOES (name) APPEAR IN ANY WAY MENTALLY BACKWARD, DULL OR SLOW?
         | 
 | 
| DA13A | 
        Does always stay in sickbed
       | 
          DOES (name) ALWAYS STAY IN SICKBED?
         | 
 | 
| DA14 | 
        May I proceed and note that you would be fine with a re-visit
       | 
          MAY I PROCEED AND NOTE THAT YOU WOULD BE FINE WITH SUCH A VISIT, IF IT OCCURS AT ALL?
         | 
 |