Questionnaires
Treatment of Lead-Exposed Children Trial (TLC)
For more information about Treatment of Lead-Exposed Children Trial questionnaires, contact Walter Rogan, M.D.
Screening
- Parent/Guardian Interview: Pre-Randomization Eligibility Review (188KB)
- Participant Referral Sheet (236KB)
- Pre-Randomization Eligibility Review (238KB)
- Residence Information: Pre-Randomization Visit 1 (242KB)
First Visit
- Participant Tracking Form (237KB)
- Review of Eligibility Lab Results: Pre-Randomization Visit 1 (236KB)
- Pre-Randomization Visit 1 (237KB)
- Repeat Eligibility Lab Work: Pre-Randomization Visit 1A (237KB)
Diaries
- Medicine Diary (222KB)
- Vitamin Diary
(219KB)
Home Assessment, Inspection & Clean-up
- Home Characteristics (238KB)
- Home Assessment Log (267KB)
- Home Visual Inspection (239KB)
- Home Floor Plans (188KB)
- Dust Wipe Collection (384KB)
- Home Cleanup (234KB)
- Environmental Eligibility Review
(233KB)
Second Visit
- Family Characteristics Interview (239KB)
- Report of Ineligibility: Visit Non-Compliance (184KB)
- Report of Non-Enrollment (233KB)
- Pre-Randomization Visit 2 or 2A
(240KB)
Initial Psychometric Assessment
- Psychometric Assessment for Younger Children (241KB)
- Review of Tapes of Psychometric Assessment for Younger Children (241KB)
- Wechsler Adult Intelligence Scale for Parents (233KB)
Randomization and Treatment
- Randomization (236KB)
- Local Lab Review (236KB)
- Initiation of Treatment (233KB)
- Review of Medications and Physical Exam: Treatment Day 7 (243KB)
- Review of Medications and Physical Exam: Treatment Day 28 (242KB)
- Treatment Day 42 (238KB)
- Retreatment (233KB)
- Adverse Drug Experience Case Report Form (238KB)
Follow-up
Medical Follow-up
- Annual Follow-up Visit (241KB)
- Midyear Follow-up Visit (238KB)
Psychometric Assessment Follow-up Visits
- Psychometric Assessment for Older Children (240KB)
- Review of Tapes of Psychometric Assessment for Older Children (236KB)
- NEPSY Session Data for TLC Children (238KB)
