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  • In the past 7 days It was hard for my child to play sports or exercise because of asthma.
  • In the past 7 days I felt afraid
  • In the past 7 days My child felt accepted by other kids his/her age.
  • In the past 7 days I had difficulty falling asleep
  • In the past 7 days I avoided or cancelled activities with my friends because I was tired from having a bad night's sleep
  • In the past 7 days, My child's body shook.
  • In the past 7 days Being tired made it hard for me to keep up with my schoolwork.
  • In the past 7 days Being tired made it hard for my child to keep up with schoolwork.
  • In the past 7 days I was in conflict with others
  • In the past 7 days My child felt scared that he/she might have trouble breathing because of asthma.
  • <u>Over the past 7 days</u>, how short of breath did you get with each of these activities? Walking 50 steps/paces on flat ground at a normal speed without stopping
  • In the past 7 days I was happy with the friends I had
  • In the past 7 days My child felt lonely.
  • In the past 7 days I was good at making friends.
  • In the past 7 days I felt sad.
  • In the past 30 days How difficult has it been to keep an erection (stay hard) when you wanted to? (If you normally use pills, injections, or a penis pump to help you get an erection, please answer this question thinking about the times that you used these aids.)
  • How would you rate the following during the LAST 4 WEEKS Your ability to have an erection
  • In the past 7 days I felt lonely
  • In the past 7 days I felt everything in my life went wrong
  • In the past 7 days, when my child was in pain he/she protected the part of his/her body that hurt.
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