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  • In the past 7 days It was hard for me to pay attention when I had pain.
  • In the past 7 days My child was able to count on his/her friends.
  • In the past 7 days, I felt peaceful.
  • Are you able to push open a heavy door?
  • In the past 7 days I could pull open heavy doors.
  • In the past 7 days I felt nervous.
  • In the past 7 days My child felt weak.
  • In the past 7 days I am satisfied with how much work I can do (include work at home)
  • In the past 7 days My child could button his/her shirt or pants.
  • In the past 7 days My child could pull open heavy doors.
  • In the past 7 days I felt worried
  • In the past 7 days, I felt cheerful.
  • In the past 7 days My child could button his/her shirt or pants.
  • In the past 7 days, My child's heart beat faster than usual, even when he/she was not exercising or playing hard.
  • In the past 4 weeks, I have trouble keeping track of what I am doing if I get interrupted
  • Thinking about your child's life, My child can reach his/her goals in life.
  • In the past 7 days My child felt angry when he/she had pain.
  • In the past 7 days It was hard for my child to run when he/she had pain.
  • In the past 4 weeks, It is hard for your child to pay attention to one thing for more than 5-10 minutes
  • In the past 7 days, everything bothered me.
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