633 Did the subject have a weakness, 634 Low intelligence tremor etc of hand that interfered with writing, drawing or folding 0. No. 1. Yes 0. No 8. No answer 1. To some extent 2. To marked extent 3. Use of one hand/arm only 4. No answer 635 Poor grasp of language that interfered 636 Slurring not specified as due to with questioning or illiterate physical defect or 0 No 1. Yes, English not mother 0. No tongue 1. Yes 2. Yes, unable to read 8. No answer 3. Yes, unable to write 4. Neither read nor write 8. No answer 637 Interview conditions unfavourable e.g. 638 Interviewee repeatedly falls asleep and noisy distracting environment. has to be awakened. 0. No 0. No 1. Yes 1. Yes 8. No answer 8. No answer DIFFICULTIES 639 Interviewee appears generally sleepy, 640 Lack of insight into present disability but does not actually fall asleep. 0. No 0. No 1. Yes 1. Yes 8. No answer 8. No answer 641 Impaired ability to focus, sustain and 642 Impaired judgement of situations and shift attention. or persons. 0. No 0. No 1. Yes 1. Yes 8. No answer 8. No answer 644 Incoherent in clear consciousness (e.g. not sleepy) irrelevant or bizarre or random
633 Did the subject have a weakness, tremor etc of hand that interfered with writing, drawing or folding 0. No 1. To some extent 2. To marked extent 3. Use of one hand/arm only 4. No answer 634 Low intelligence 0. No. 1. Yes 8. No answer 635 Poor grasp of language that interfered with questioning or illiterate 0 No 1. Yes, English not mother tongue 2. Yes, unable to read 3. Yes, unable to write 4. Neither read nor write 8. No answer 636 Slurring not specified as due to physical defect or 0. No 1. Yes 8. No answer 637 Interview conditions unfavourable e.g. noisy distracting environment. 0. No 1. Yes 8. No answer 638 Interviewee repeatedly falls asleep and has to be awakened. 0. No 1. Yes 8. No answer 639 Interviewee appears generally sleepy, but does not actually fall asleep. 0. No 1. Yes 8. No answer DIFFICULTIES 640 Lack of insight into present disability 0. No 1. Yes 8. No answer 641 Impaired ability to focus, sustain and shift attention. 0. No 1. Yes 8. No answer 642 Impaired judgement of situations and or persons. 0. No 1. Yes 8. No answer 644 Incoherent in clear consciousness (e.g. not sleepy) irrelevant or bizarre or random
CFAS-Questionnaire-part-IIv5-1110081.docx