Design for Survey of Persons with Mental Retardation and Developmental Disabilities: Summary of Recommendations for Survey Questions and Screening Criteria. Design for Survey of Persons with Mental Retardation and Developmental Disabilities: Summary of Recommendations for Survey Questions and Screening Criteria : Table 9

11/29/1989

: Table 9

Independence in Selecting/Arranging Services and Activities: 
   personal care attendantChooses unassisted, chooses with assistance from personal unpaid friend, chooses with assistance of family member, chooses with assistance of legal guardian, chooses with assistance of agency/school staff, does not choose/choice made by unpaid friend/family member/legal guardian/agency or school staff
   residenceChooses unassisted, chooses with assistance from personal unpaid friend, chooses with assistance of family member, chooses with assistance of legal guardian, chooses with assistance of agency/school staff, does not choose/choice made by unpaid friend/family member/legal guardian/agency or school staff 2
   current jobChooses unassisted, chooses with assistance from personal unpaid friend, chooses with assistance of family member, chooses with assistance of legal guardian, chooses with assistance of agency/school staff, does not choose/choice made by unpaid friend/family member/legal guardian/agency or school staff 2
   leisure activitiesChooses unassisted, chooses with assistance from personal unpaid friend, chooses with assistance of family member, chooses with assistance of legal guardian, chooses with assistance of agency/school staff, does not choose/choice made by unpaid friend/family member/legal guardian/agency or school staff 2
Defend/Advocate for OneselfHave legal guardian: yes/no2 Have representative payee: yes/no2 Give consent for medical care: unassisted, with assistance from personal unpaid friend, with assistance of family member, with assistance of legal guardian, with assistance of agency/school staff, does not give consent/consent given by unpaid friend/family member/legal guardian/agency or school staff2
Financial ManagementShop for yourself: yes/no2 Pay money to clerk: by self, someone helps Who helps: __________ Person receives bills (i.e. telephone bill: yes/no Take care of bills: by self, someone helps Who helps: __________ Have bank account: yes/no Make deposits/withdrawals: by self, someone helps Who helps: __________
Need for SupervisionFeel comfortable being alone for 1+ hours at a time: yes/no2 Level of supervision in past week: minimal (every now and then), during daytime hours only, constant/round-the-clock2 Length of time (months/years) this level has been required