OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

The Natural History of Spina Bifida in Children Pilot Project

ICR 200809-0920-002 · OMB 0920-0799 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form No number Child - Bracken Basic Concept Scale - School Readiness Composite Form New Available
Form No number Child - Wide Range Assessment of Visual Motor Abilities Form New Available
Form No number Child - NEPSY-II Form New Repair queued
Form No number Child - Peabody Picture Vocabulary Test Form New Available
Form No number Child - Differential Abilities Scale Form New Available
Form No number Parent - Children's Healthcare of Atlanta Patient History Questionnaire (in-depth evaluation) Form New Repair queued
Form No number Parent - Adaptive Behavior Assessment System (in-depth evaluation) Form New Available
Form No number Parent - Behavior Assessment System for Children (in-depth evaluation) Form New Available
Form No number Parent - Behavior Rating Inventory of Executive Function, Preschool Version Form New Available
Form No number Parent - Pediatric Evaluation of Disability Inventory Form New Available
Form No number Parent - McMaster Family Assessment Device Form New Available
Form No number Parent - Survey Form New Available
Supporting Statement Section B.doc Supporting Statement B Uploaded 2008-08-26 Available
Attachment O.doc Supplementary Document Uploaded 2008-08-26 Available
Attachment N.doc Supplementary Document Uploaded 2008-08-26 Available
Attachment M.doc Supplementary Document Uploaded 2008-08-26 Available
Attachment L.doc Supplementary Document Uploaded 2008-08-26 Available
Attachment K.doc Supplementary Document Uploaded 2008-08-26 Available
Attachment J.doc Supplementary Document Uploaded 2008-08-26 Available
Attachment I.doc Supplementary Document Uploaded 2008-08-26 Available
Attachment H.doc Supplementary Document Uploaded 2008-08-26 Available
Attachment G.doc Supplementary Document Uploaded 2008-08-26 Available
Attachment F.doc Supplementary Document Uploaded 2008-08-26 Available
Attachment E.doc Supplementary Document Uploaded 2008-08-26 Repair queued
Attachment D.doc Supplementary Document Uploaded 2008-08-26 Available
Attachment B.doc Supplementary Document Uploaded 2008-08-26 Available
Attachment A.doc Supplementary Document Uploaded 2008-08-26 Available
Supporting Statement Section A_Aug_20_2008_revised.doc Supporting Statement A Uploaded 2008-08-29 Available
IC Document Collections
IC IDCollectionTypeStatusForm
186666 SB Clinic Coordinator Recruitment Effort Other-Burden Description New
186665 Child - Bracken Basic Concept Scale - School Readiness Composite Form New
186664 Child - Wide Range Assessment of Visual Motor Abilities Form New
186663 Child - NEPSY-II Form New
186662 Child - Peabody Picture Vocabulary Test Form New
186661 Child - Differential Abilities Scale Form New
186660 Parent - Children's Healthcare of Atlanta Patient History Questionnaire (in-depth evaluation) Form New
186659 Parent - Adaptive Behavior Assessment System (in-depth evaluation) Form New
186658 Parent - Behavior Assessment System for Children (in-depth evaluation) Form New
186657 Parent - Behavior Rating Inventory of Executive Function, Preschool Version Form New
186656 Parent - Pediatric Evaluation of Disability Inventory Form New
186655 Parent - McMaster Family Assessment Device Form New
186654 Parent - Survey Form New
ICR Details
0920-0799 200809-0920-002
Historical Active
HHS/CDC
The Natural History of Spina Bifida in Children Pilot Project
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 01/08/2009
Retrieve Notice of Action (NOA) 09/18/2008
Approval is based on changes agreed upon via email memo dated 01/05/09. For the full study, we will need a specific justification for each of the questions asked (i.e. the utility of the data collected).
  Inventory as of this Action Requested Previously Approved
01/31/2011 24 Months From Approved
246 0 0
94 0 0
0 0 0
Neural tube defects are still ranked as one of the most common potentially disabling conditions in the U.S. The long-term purpose of this Spina bifida (SB) project is to increase knowledge about the natural history of SB by prospectively studying children who were born with this potentially disabling condition.
PL: Pub.L. 108 - 154 317C Name of Law: Birth Defects and Developmental Disabilities Act of 2003
  
None
Not associated with rulemaking
  73 FR 6727 02/05/2008
73 FR 50820 08/28/2008
No
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 246 0 0 246 0 0
Annual Time Burden (Hours) 94 0 0 94 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new data collection.
$168,187
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
Carol Walker 4046394773
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/18/2008