Canadian Survey on Disability - 2017

For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.

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Table of Contents

DISABILITY SCREENING QUESTIONS (DSQ)

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_R005

The following questions are about difficulties a person may have doing certain activities. Only difficulties or long-term conditions that have lasted or are expected to last for six months or more should be considered.

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q005

Do you have any difficulty seeing (even when wearing glasses or contact lenses)?

  • 1: No
  • 2: Sometimes
  • 3: Often
  • 4: Always

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q010

Do you have any difficulty hearing (even when using a hearing aid)?

  • 1: No
  • 2: Sometimes
  • 3: Often
  • 4: Always

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q015

Do you have any difficulty walking, using stairs, using your hands or fingers or doing other physical activities?

  • 1: No
  • 2: Sometimes
  • 3: Often
  • 4: Always

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q020

Do you have any difficulty learning, remembering or concentrating?

  • 1: No
  • 2: Sometimes
  • 3: Often
  • 4: Always

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q025

Do you have any emotional, psychological or mental health conditions?

  • 1: No
  • 2: Sometimes
  • 3: Often
  • 4: Always

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q030

Do you have any other health problem or long-term condition that has lasted or is expected to last for six months or more?

  • 1: No
  • 2: Sometimes
  • 3: Often
  • 4: Always

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q035

Do you wear glasses or contact lenses to improve your vision?

  • 1: Yes
  • 2: No
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q040

[With your glasses or contact lenses, which/Which] of the following best describes your ability to see?

  • 1: No difficulty seeing
  • 2: Some difficulty seeing
  • 3: A lot of difficulty seeing
  • 4: [You] are legally blind
  • 5: [You] are blind
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q045

At what age did you begin having [difficulty seeing/a seeing condition]?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q050

How often does this [difficulty seeing/seeing condition] limit your daily activities?

  • 1: Never
  • 2: Rarely
  • 3: Sometimes
  • 4: Often
  • 5: Always
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q055

At what age did this [difficulty seeing/seeing condition] begin to limit your daily activities?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q060

Do you use a hearing aid or cochlear implant?

  • 1: Yes
  • 2: No
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q065

[With your hearing aid or cochlear implant, which/Which] of the following best describes your ability to hear?

  • 1: No difficulty hearing
  • 2: Some difficulty hearing
  • 3: A lot of difficulty hearing
  • 4: [You] cannot hear at all
  • 5: [You] are Deaf
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q070

At what age did you begin having [difficulty hearing/a hearing condition]?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q075

How often does this [difficulty hearing/hearing condition] limit your daily activities?

  • 1: Never
  • 2: Rarely
  • 3: Sometimes
  • 4: Often
  • 5: Always
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q080

At what age did this [difficulty hearing/hearing condition] begin to limit your daily activities?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_R085

The following questions are about your ability to move around, even when using an aid such as a cane. Only difficulties or long-term conditions that have lasted or are expected to last for six months or more should be considered. Only consider aids that provide minimal support such as a cane, walking stick or crutches.

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q085

How much difficulty do you have walking on a flat surface for 15 minutes without resting?

  • 1: No difficulty
  • 2: Some difficulty
  • 3: A lot of difficulty
  • 4: [You] cannot do at all
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q090

How much difficulty do you have walking up or down a flight of stairs, about 12 steps without resting?

  • 1: No difficulty
  • 2: Some difficulty
  • 3: A lot of difficulty
  • 4: [You] cannot do at all
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q095

At what age did you begin having [difficulty walking on flat surfaces/difficulty using the stairs/difficulty walking on flat surfaces and using stairs]?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q100

How often [does this difficulty walking/does this difficulty using stairs/do these difficulties] limit your daily activities?

  • 1: Never
  • 2: Rarely
  • 3: Sometimes
  • 4: Often
  • 5: Always
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q105

At what age did [this difficulty walking/this difficulty using stairs/these difficulties walking and using stairs] begin to limit your daily activities?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_R110

The next questions deal with flexibility and dexterity. Only difficulties or long-term conditions that have lasted or are expected to last for six months or more should be considered.

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q110

How much difficulty do you have bending down and picking up an object from the floor?

  • 1: No difficulty
  • 2: Some difficulty
  • 3: A lot of difficulty
  • 4: [You] cannot do at all
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q115

How much difficulty do you have reaching in any direction, for example, above your head?

  • 1: No difficulty
  • 2: Some difficulty
  • 3: A lot of difficulty
  • 4: [You] cannot do at all
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q120

At what age did you begin having [difficulty bending and picking up an object/difficulty reaching/difficulty bending and picking up an object and difficulty reaching]?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q125

How often [does this difficulty bending and picking up an object/does this difficulty reaching/do these difficulties] limit your daily activities?

  • 1: Never
  • 2: Rarely
  • 3: Sometimes
  • 4: Often
  • 5: Always
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q130

At what age did [this difficulty bending and picking up an object/this difficulty reaching/these difficulties bending and picking up an object and reaching] begin to limit your daily activities?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q135

How much difficulty do you have using your fingers to grasp small objects like a pencil or scissors?

  • 1: No difficulty
  • 2: Some difficulty
  • 3: A lot of difficulty
  • 4: [You] cannot do at all
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q140

At what age did you begin having difficulty using your fingers to grasp small objects?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q145

How often does this difficulty using your fingers limit your daily activities?

  • 1: Never
  • 2: Rarely
  • 3: Sometimes
  • 4: Often
  • 5: Always
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q150

At what age did this difficulty using your fingers to grasp small objects begin to limit your daily activities?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_R155

The following questions are about pain due to a long-term condition that has lasted or is expected to last for six months or more.

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q155

Do you have pain that is always present?

  • 1: Yes
  • 2: No
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q160

Do you [also/blank] have periods of pain that reoccur from time to time?

  • 1: Yes
  • 2: No
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q165

At what age did you begin having this pain?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q170

How often does this pain limit your daily activities?

  • 1: Never
  • 2: Rarely
  • 3: Sometimes
  • 4: Often
  • 5: Always
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q175

At what age did this pain begin to limit your daily activities?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q180

When you are experiencing this pain, how much difficulty do you have with your daily activities?

  • 1: No difficulty
  • 2: Some difficulty
  • 3: A lot of difficulty
  • 4: [You] cannot do most activities
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q185

Do you think you have a condition that makes it difficult in general for you to learn? This may include learning disabilities such as dyslexia, hyperactivity, attention problems, etc.

  • 1: Yes
  • 2: No
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q190

Has a teacher, doctor or other health care professional ever said that you had a learning disability?

  • 1: Yes
  • 2: No
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q195

At what age did you begin having a condition that makes it difficult in general for you to learn?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q200

How often are your daily activities limited by this condition?

  • 1: Never
  • 2: Rarely
  • 3: Sometimes
  • 4: Often
  • 5: Always
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q205

At what age did this learning condition begin to limit your daily activities?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q210

How much difficulty do you have with your daily activities because of this condition?

  • 1: No difficulty
  • 2: Some difficulty
  • 3: A lot of difficulty
  • 4: [You] cannot do most activities
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q215

Has a doctor, psychologist or other health care professional ever said that you had a developmental disability or disorder? This may include Down syndrome, autism, Asperger syndrome, mental impairment due to lack of oxygen at birth, etc.

  • 1: Yes
  • 2: No
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q220

At what age were you diagnosed with a developmental disability or disorder?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q225

How often are your daily activities limited by this condition?

  • 1: Never
  • 2: Rarely
  • 3: Sometimes
  • 4: Often
  • 5: Always
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q230

At what age did this developmental disability or disorder begin to limit your daily activities?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q235

How much difficulty do you have with your daily activities because of this condition?

  • 1: No difficulty
  • 2: Some difficulty
  • 3: A lot of difficulty
  • 4: [You] cannot do most activities
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_R240

Again, please answer for any conditions that have lasted or are expected to last for six months or more. Please remember that your answers will be kept strictly confidential.

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q240

Do you have any emotional, psychological or mental health conditions?

  • 1: Yes
  • 2: No
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q245

[You mentioned earlier that you have an emotional, psychological or mental health condition./blank] At what age did your [condition/emotional, psychological or mental health condition] begin?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q250

How often are your daily activities limited by this condition?

  • 1: Never
  • 2: Rarely
  • 3: Sometimes
  • 4: Often
  • 5: Always
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q255

At what age did this mental health condition begin to limit your daily activities?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q260

When you are experiencing this condition, how much difficulty do you have with your daily activities?

  • 1: No difficulty
  • 2: Some difficulty
  • 3: A lot of difficulty
  • 4: [You] cannot do most activities
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q265

Do you have any ongoing memory problems or periods of confusion?

  • 1: Yes
  • 2: No
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q270

At what age did you begin having memory problems?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q275

How often are your daily activities limited by this problem?

  • 1: Never
  • 2: Rarely
  • 3: Sometimes
  • 4: Often
  • 5: Always
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q280

At what age did these memory problems begin to limit your daily activities?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q285

How much difficulty do you have with your daily activities because of this problem?

  • 1: No difficulty
  • 2: Some difficulty
  • 3: A lot of difficulty
  • 4: [You] cannot do most activities
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q290

Do you have any other health problem or long-term condition that has lasted or is expected to last for six months or more?

  • 1: Yes - specify:
  • 2: No

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q295

At what age did you begin having this health problem or condition?

Min = 0; Max = 121

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q300

How often does this health problem or condition limit your daily activities?

  • 1: Never
  • 2: Rarely
  • 3: Sometimes
  • 4: Often
  • 5: Always
  • 9: DK

DISABILITY SCREENING QUESTIONS (DSQ) - Question identifier:DSQ_Q305

At what age did this health problem or condition begin to limit your daily activities?

Min = 0; Max = 121

EPISODIC DISABILITIES (EPD)

EPISODIC DISABILITIES (EPD) - Question identifier:EPD_R05

The next questions deal with changes that you may or may not be experiencing with the impact of your conditions over time. Consider the impact of all conditions or limitations that you have.

EPISODIC DISABILITIES (EPD) - Question identifier:EPD_Q05

Do you ever have periods of one month or more when you do not feel limited in your daily activities due to your overall condition?

  • 1: Yes
  • 2: No

EPISODIC DISABILITIES (EPD) - Question identifier:EPD_Q10

Is your ability to do your daily activities

  • 1: getting better
  • 2: getting worse
  • 3: staying about the same
  • 4: you are able to do more activities during some periods but fewer activities during other periods

EPISODIC DISABILITIES (EPD) - Question identifier:EPD_Q15

How much longer do you expect your limitations will last?

  • 1: Less than 1 year
  • 2: 1 year but less than 2 years
  • 3: 2 years or more but not likely permanent
  • 4: Most likely permanent
  • 5: Unknown duration

MAIN CONDITION (MC)

MAIN CONDITION (MC) - Question identifier:MC_R05

You indicated earlier that you have a condition or health problem that limits your daily activities.

MAIN CONDITION (MC) - Question identifier:MC_Q05

What is the main medical condition which causes you the most difficulty or limits your activities the most?

Long Answer Length = 80

MAIN CONDITION (MC) - Question identifier:MC_Q10

Which of the following best describes the cause of this condition?

  • 01: Existed at birth
  • 02: Hereditary
  • 03: Disease or illness
  • 04: Work conditions
  • 05: Accident or injury
  • 06: Aging
  • 07: Stress or trauma
  • 08: Undetermined cause
  • 09: Other cause - specify:
  • 99: DK

MAIN CONDITION (MC) - Question identifier:MC_Q15

What type of accident or injury?

  • 1: At home
  • 2: Motor vehicle
  • 3: At work
  • 4: Sports related
  • 5: Another type of accident or injury
  • 9: DK

MAIN CONDITION (MC) - Question identifier:MC_Q20A

Do you have a second condition that causes you difficulty or limits your activities?

  • 1: Yes
  • 2: No

MAIN CONDITION (MC) - Question identifier:MC_Q20B

What is that condition?

Long Answer Length = 80

MAIN CONDITION (MC) - Question identifier:MC_Q25

Which of the following best describes the cause of this condition?

  • 01: Existed at birth
  • 02: Hereditary
  • 03: Disease or illness
  • 04: Work conditions
  • 05: Accident or injury
  • 06: Aging
  • 07: Stress or trauma
  • 08: Undetermined cause
  • 09: Other cause - specify:
  • 99: DK

MAIN CONDITION (MC) - Question identifier:MC_Q30

What type of accident or injury?

  • 1: At home
  • 2: Motor vehicle
  • 3: At work
  • 4: Sports related
  • 5: Another type of accident or injury
  • 9: DK

AIDS AND ASSISTIVE DEVICES - HEARING (AADH)

AIDS AND ASSISTIVE DEVICES - HEARING (AADH) - Question identifier:AADH_R05

Now, some questions about aids and assistive devices that you may use to help with a hearing condition.

An assistive device is any device or tool designed or adapted to help a person perform a particular task or activity.

AIDS AND ASSISTIVE DEVICES - HEARING (AADH) - Question identifier:AADH_Q05

Because of your condition, do you use

  • 01: a hearing aid
  • 02: a cochlear implant or another implant
  • 03: closed captioning or subtitles for television or movies
  • 04: visual or vibrating alarms or alerts
  • 05: amplifiers (e.g., FM, loop systems or infra-red)
  • 06: telephone-related devices (e.g., TTY, volume controllers, flashers or relay services)
  • 07: live video streaming using sign language or other means to communicate
  • 08: another aid or assistive device — specify:
  • 09: None

AIDS AND ASSISTIVE DEVICES - HEARING (AADH) - Question identifier:AADH_Q10

Are there any aids or assistive devices for a hearing condition that you think you need but do not have?

  • 1: Yes
  • 2: No

AIDS AND ASSISTIVE DEVICES - HEARING (AADH) - Question identifier:AADH_Q15

Which aids or assistive devices do you need but do not have?

  • 01: Hearing aid
  • 02: Cochlear implant or other implant
  • 03: Closed captioning or subtitles for television or movies
  • 04: Visual or vibrating alarms or alerts
  • 05: Amplifiers (e.g., FM, loop systems or infra-red)
  • 06: Telephone-related devices (e.g., TTY, volume controllers, flashers or relay services)
  • 07: Live video streaming using sign language or other means to communicate
  • 08: Other aid or assistive device - specify:
  • 09: None

AIDS AND ASSISTIVE DEVICES - HEARING (AADH) - Question identifier:AADH_Q20

Why do you not have a hearing aid?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - HEARING (AADH) - Question identifier:AADH_Q25

Why do you not have a cochlear implant or other implant?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - HEARING (AADH) - Question identifier:AADH_Q30

Why do you not have closed caption or subtitles for television or movies?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - HEARING (AADH) - Question identifier:AADH_Q35

Why do you not have visual or vibrating alarms or alerts?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - HEARING (AADH) - Question identifier:AADH_Q40

Why do you not have amplifiers?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - HEARING (AADH) - Question identifier:AADH_Q45

Why do you not have telephone-related devices?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - HEARING (AADH) - Question identifier:AADH_Q50

Why do you not have live video streaming using sign language or other means to communicate?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - HEARING (AADH) - Question identifier:AADH_Q55

Why do you not have [AADH_Q15 Category 08 response/the other aid or assistive device]?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - HEARING (AADH) - Question identifier:AADH_R60

The next questions ask about ways you may communicate to help with a hearing condition.

AIDS AND ASSISTIVE DEVICES - HEARING (AADH) - Question identifier:AADH_Q60

Do you lip read?

  • 1: Yes
  • 2: No

AIDS AND ASSISTIVE DEVICES - HEARING (AADH) - Question identifier:AADH_Q65

Do you use sign language such as ASL or LSQ?

  • 1: Yes
  • 2: No

AIDS AND ASSISTIVE DEVICES - HEARING (AADH) - Question identifier:AADH_Q70

How often do you use sign language?

  • 1: Every day
  • 2: At least once a week
  • 3: At least once a month
  • 4: At least once every six months
  • 5: Less than once every six months

AIDS AND ASSISTIVE DEVICES - HEARING (AADH) - Question identifier:AADH_Q75

Do you ever use a sign language interpreter?

  • 1: Yes
  • 2: No

AIDS AND ASSISTIVE DEVICES - HEARING (AADH) - Question identifier:AADH_Q80

How often do you use a sign language interpreter?

  • 1: Every day
  • 2: At least once a week
  • 3: At least once a month
  • 4: At least once every six months
  • 5: Less than once every six months

AIDS AND ASSISTIVE DEVICES - VISION (AADV)

AIDS AND ASSISTIVE DEVICES - VISION (AADV) - Question identifier:AADV_R05

Now some questions about aids and assistive devices that you may use to help with a seeing condition.

An assistive device is any device or tool designed or adapted to help a person perform a particular task or activity.

AIDS AND ASSISTIVE DEVICES - VISION (AADV) - Question identifier:AADV_Q05

Because of your condition, do you use

  • 01: eye glasses or contact lenses
  • 02: a white cane or identification cane
  • 03: recording equipment or portable note-taking device
  • 04: magnifiers
  • 05: large print reading materials
  • 06: dark lined paper or dark ink pens
  • 07: Braille reading materials or manual Brailler
  • 08: a device with oversized buttons (e.g., remote control or telephone)
  • 09: audio or described video for television programs
  • 10: closed-circuit devices (e.g., CCTV)
  • 11: another aid or assistive device - specify:
  • 12: None

AIDS AND ASSISTIVE DEVICES - VISION (AADV) - Question identifier:AADV_Q10

Are there any aids or assistive devices for a seeing condition that you think you need but do not have?

  • 1: Yes
  • 2: No

AIDS AND ASSISTIVE DEVICES - VISION (AADV) - Question identifier:AADV_Q15

Which aids or assistive devices do you need but do not have?

  • 01: Eye glasses or contact lenses
  • 02: White cane or identification cane
  • 03: Recording equipment or a portable note-taking device
  • 04: Magnifiers
  • 05: Large print reading materials
  • 06: Dark lined paper or dark ink pens
  • 07: Braille reading materials or a manual Brailler
  • 08: Device with oversized buttons (e.g., remote control or telephone)
  • 09: Audio or described video for television programs
  • 10: Closed-circuit devices (e.g., CCTV)
  • 11: Other aid or assistive device - specify:
  • 12: None

AIDS AND ASSISTIVE DEVICES - VISION (AADV) - Question identifier:AADV_Q20

Why do you not have eye glasses or contact lenses?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - VISION (AADV) - Question identifier:AADV_Q25

Why do you not have a white cane or identification cane?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - VISION (AADV) - Question identifier:AADV_Q30

Why do you not have recording equipment or a portable note-taking device?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - VISION (AADV) - Question identifier:AADV_Q35

Why do you not have magnifiers?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - VISION (AADV) - Question identifier:AADV_Q40

Why do you not have large print reading materials?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - VISION (AADV) - Question identifier:AADV_Q45

Why do you not have dark lined paper or dark ink pens?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - VISION (AADV) - Question identifier:AADV_Q50

Why do you not have Braille reading materials or a manual Brailler?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - VISION (AADV) - Question identifier:AADV_Q55

Why do you not have a device with oversized buttons?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - VISION (AADV) - Question identifier:AADV_Q60

Why do you not have audio or described video for television programs?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - VISION (AADV) - Question identifier:AADV_Q65

Why do you not have closed-circuit devices?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - VISION (AADV) - Question identifier:AADV_Q70

Why do you not have [AADV_Q15 Category 11 response/the other aid or assistive device]?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM)

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_R005

Now some questions about aids and assistive devices that you may use for moving around, to help with bending or reaching or to help with fine motor skills.

An assistive device is any device or tool designed or adapted to help a person perform a particular task or activity.

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q005

Because of your condition, do you use

  • 01: a cane, a walking stick or crutches
  • 02: a walker
  • 03: a scooter
  • 04: a manual wheelchair
  • 05: a motorized wheelchair
  • 06: orthopaedic footwear
  • 07: an orthotic or a brace
  • 08: a prosthetic device or an artificial limb
  • 09: a grasping tool or a reach extender
  • 10: adapted tools, utensils or special grips
  • 11: a device for dressing (e.g., button hook, zipper pull, long-handled shoe horn)
  • 12: a device with oversized buttons (e.g., remote control or telephone)
  • 13: None

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_R010

The next questions are about aids, assistive devices and accessibility features you may use in your residence to help with moving around, to help with bending or reaching or to help with fine motor skills.

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q010

Because of your condition, at your residence, do you use

  • 1: bathroom aids (e.g., raised toilet seat or grab bars)
  • 2: a walk-in bath or shower
  • 3: an access ramp or a ground-level entrance
  • 4: a lift device or an elevator
  • 5: automatic or easy to open doors
  • 6: None

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q015

Because of your condition, at your residence, do you have

  • 1: widened doorways or hallways
  • 2: lowered counters in the kitchen or bathroom
  • 3: None

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q020A

Do you use any other aid, assistive device or accessibility feature for moving around, to help with bending or reaching or to help with fine motor skills?

  • 1: Yes
  • 2: No

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q020B

What is the other aid or assistive device that you use?

Long Answer Length = 80

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q025

Are there any aids or assistive devices for moving around, to help with bending or reaching or to help with fine motor skills that you think you need but do not have?

  • 1: Yes
  • 2: No

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q030

Which of the following aids or assistive devices do you need but do not have?

  • 01: Cane, walking stick or crutches
  • 02: Walker
  • 03: Scooter
  • 04: Manual wheelchair
  • 05: Motorized wheelchair
  • 06: Orthopaedic footwear
  • 07: Orthotic or brace
  • 08: Prosthetic device or artificial limb
  • 09: Grasping tool or reach extender
  • 10: Adapted tools, utensils or special grips
  • 11: Device for dressing (e.g., button hook, zipper pull, long-handled shoe horn)
  • 12: Device with oversized buttons (e.g., remote control or telephone)
  • 13: Bathroom aids (e.g., raised toilet seat or grab bars)
  • 14: Walk-in bath or shower
  • 15: Access ramp or a ground-level entrance
  • 16: Lift device or elevator
  • 17: Automatic or easy to open doors
  • 18: Widened doorways or hallways
  • 19: Lowered counters in the kitchen or bathroom
  • 20: Other aid or assistive device - specify:
  • 21: None

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q035

Why do you not have a cane, walking stick or crutches?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q040

Why do you not have a walker?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q045

Why do you not have a scooter?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q050

Why do you not have a manual wheelchair?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q055

Why do you not have a motorized wheelchair?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q060

Why do you not have orthopaedic footwear?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q065

Why do you not have an orthotic or brace?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q070

Why do you not have a prosthetic device or artificial limb?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q075

Why do you not have a grasping tool or reach extender?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q080

Why do you not have adapted tools, utensils or special grips?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q085

Why do you not have a device for dressing?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q090

Why do you not have device with oversized buttons?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q095

Why do you not have bathroom aids?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q100

Why do you not have a walk-in bath or shower?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q105

Why do you not have an access ramp or a ground-level entrance?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q110

Why do you not have a lift device or elevator?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q115

Why do you not have automatic or easy to open doors?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q120

Why do you not have widened doorways or hallways?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q125

Why do you not have lowered counters in the kitchen or bathroom?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISTIVE DEVICES - MOBILITY AND AGILITY (AADM) - Question identifier:AADM_Q130

Why do you not have [AADM_Q030 Category 20 response/the other aid or assistive device]?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - LEARNING AND DEVELOPMENTAL (AADL)

AIDS AND ASSISITIVE DEVICES - LEARNING AND DEVELOPMENTAL (AADL) - Question identifier:AADL_R05

Now some questions about aids and assistive devices that you may use to help with learning or developmental difficulties.

An assistive device is any device or tool designed or adapted to help a person perform a particular task or activity.

AIDS AND ASSISITIVE DEVICES - LEARNING AND DEVELOPMENTAL (AADL) - Question identifier:AADL_Q05

Because of your condition, do you use

  • 1: recording equipment or a portable note-taking device
  • 2: a portable spell checker (Exclude cell phone or smartphone)
  • 3: another aid or assistive device - specify:
  • 4: None

AIDS AND ASSISITIVE DEVICES - LEARNING AND DEVELOPMENTAL (AADL) - Question identifier:AADL_Q10

Are there any aids or assistive devices for learning that you think you need but do not have?

  • 1: Yes
  • 2: No

AIDS AND ASSISITIVE DEVICES - LEARNING AND DEVELOPMENTAL (AADL) - Question identifier:AADL_Q15

Which aids or assistive devices do you need but do not have?

  • 1: Recording equipment or portable note-taking device
  • 2: Portable spell checker (Exclude cell phone or smartphone)
  • 3: Other aid or assistive device - specify:
  • 4: None

AIDS AND ASSISITIVE DEVICES - LEARNING AND DEVELOPMENTAL (AADL) - Question identifier:AADL_Q20

Why do you not have recording equipment or a portable note-taking device?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - LEARNING AND DEVELOPMENTAL (AADL) - Question identifier:AADL_Q25

Why do you not have a portable spell checker?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - LEARNING AND DEVELOPMENTAL (AADL) - Question identifier:AADL_Q30

Why do you not have [AADL_Q15 Category 3 response/the other aid or assistive device]?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - ALL (AADA)

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_R005A

The following questions are about various aids, devices and specialized equipment you use for any of your conditions.

You may feel that some of these questions do not apply to you or may seem similar to questions already asked, but it is important that we ask the same questions of everyone.

Please do not include medication taken for your conditions, as this is included in a later section.

An assistive device is any device or tool designed or adapted to help a person perform a particular task or activity.

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_R005B

Because of your condition, do you use

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q005A

A. a cell phone, smartphone or smartwatch with specialized features to help with your condition

  • 1: Yes
  • 2: No

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q005B

B. a computer, laptop or tablet with specialized software or other adaptations to help with your condition

  • 1: Yes
  • 2: No

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q010

Because of your condition, do any of your devices have speech to text, text to speech or voice recognition software?

  • 1: Yes
  • 2: No

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q015

Because of your condition, do any of your devices have a screen magnification software?

  • 1: Yes
  • 2: No

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q020

Because of your condition, do any of your devices have a screen reader?

  • 1: Yes
  • 2: No

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q025

Because of your condition, do any of your devices have any other software or adaptation to help with a condition?

  • 1: Yes
  • 2: No

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q030

Because of your condition, do you use a device for playing audio books or e-books?

  • 1: Yes
  • 2: No

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q035

Are audio books or e-books generally available in an accessible format for your condition?

  • 1: Yes
  • 2: No

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q040

Because of your condition, do you use

  • 01: a service animal
  • 02: orthopaedic footwear
  • 03: an orthotic or brace
  • 04: supportive devices (e.g., therapeutic cushions or pillows, special chairs or an adjustable bed)
  • 05: an electrotherapy device for pain (e.g., a TENS machine)
  • 06: a voice amplifier
  • 07: diabetic aids (e.g., blood glucose monitor or needles)
  • 08: oxygen supplies
  • 09: another aid or assistive device - specify:
  • 10: None

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q045

Are there any aids, devices or specialized equipment that you think you need but do not have?

  • 1: Yes
  • 2: No

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q050

Which aids, devices or specialized equipment do you need but do not have?

  • 01: Cell phone, smartphone or smartwatch with specialized features
  • 02: Computer, laptop or tablet with specialized software or other adaptations
  • 03: Speech to text, text to speech or voice recognition software
  • 04: Screen magnification software
  • 05: Screen reader
  • 06: Other software or adaptation to help with a condition
  • 07: Device for playing audio books or e-books
  • 08: Service animal
  • 09: Orthopaedic footwear
  • 10: Orthotic or brace
  • 11: Supportive devices (e.g., therapeutic cushions or pillows, special chairs or an adjustable bed)
  • 12: Electrotherapy device for pain (e.g., a TENS machine)
  • 13: Voice amplifier
  • 14: Diabetic aids (e.g., blood glucose monitor or needles)
  • 15: Oxygen supplies
  • 16: Other aid or assistive device - specify:
  • 17: None

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q055

Why do you not have a cellphone, smartphone or smartwatch with specialized features?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q060

Why do you not have a computer, laptop or tablet with specialized software or other adaptation?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q065

Why do you not have speech to text, text to speech or voice recognition software?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q070

Why do you not have a screen magnification software?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q075

Why do you not have a screen reader?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q080

Why do you not have other software or adaptation to help with a condition?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q085

Why do you not have a device for playing audio books or e-books?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q090

Why do you not have a service animal?

  • 1: Cost
  • 2: Do not want one
  • 3: Not available (e.g., unsure how or where to get one, not available locally, on a waiting list, etc.)
  • 4: Other reasons

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q095

Why do you not have orthopaedic footwear?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q100

Why do you not have an orthotic or brace?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q105

Why do you not have supportive devices?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q110

Why do you not have an electrotherapy device for pain?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q115

Why do you not have a voice amplifier?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q120

Why do you not have diabetic aids?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q125

Why do you not have oxygen supplies?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q130

Why do you not have [AADA_Q050 Category 16 response/the other aid or assistive device]?

  • 1: Cost (e.g., not covered by insurance, too expensive to purchase or repair, etc.)
  • 2: Do not want to or not willing to upgrade from current aid or assistive device
  • 3: Not available (e.g., unsure how or where to get aid or assistive device, not available locally, on a waiting list, etc.)
  • 4: Available aids cannot be adapted
  • 5: Other reasons

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q135

In the past 12 months, did you have any expenses for the purchase, repair or maintenance of your aids or assistive devices for which you will not be reimbursed?

  • 1: Yes
  • 2: No

AIDS AND ASSISITIVE DEVICES - ALL (AADA) - Question identifier:AADA_Q140

What is the total amount of these expenses for which you will not be reimbursed?

  • 1: Less than $100
  • 2: $100 to less than $200
  • 3: $200 to less than $500
  • 4: $500 to less than $1,000
  • 5: $1,000 to less than $2,000
  • 6: $2,000 to less than $5,000
  • 7: $5,000 or more
  • 9: DK

MEDICATION USE (MED)

MEDICATION USE (MED) - Question identifier:MED_R05

The next questions are about the use of prescription medications taken for any conditions that have lasted or are expected to last for six months or more.

MEDICATION USE (MED) - Question identifier:MED_Q05

Because of your condition, do you take any prescription medications at least once a week?

  • 1: Yes
  • 2: No

MEDICATION USE (MED) - Question identifier:MED_Q10

In the past 12 months, were you ever unable to get prescription medications you were supposed to take because of the cost?

  • 1: Yes
  • 2: No

MEDICATION USE (MED) - Question identifier:MED_Q15

In the past 12 months, did you ever take prescription medication less often than you were supposed to because of the cost?

  • 1: Yes
  • 2: No

HELP RECEIVED (HRE)

HELP RECEIVED (HRE) - Question identifier:HRE_R05

Now, some questions on help you may receive with your daily activities because of any of your conditions.

HELP RECEIVED (HRE) - Question identifier:HRE_Q05

Because of your condition, do you usually receive help with any of the following activities?

  • 01: Preparing meals
  • 02: Everyday housework (e.g., dusting or tidying up)
  • 03: Heavy household chores (e.g., yard work, snow removal or spring cleaning)
  • 04: Getting to appointments or running errands (e.g., shopping for groceries or other essential items)
  • 05: Looking after personal finances (e.g., making bank transactions or paying bills)
  • 06: Personal care (e.g., washing, dressing or taking medication)
  • 07: Basic medical care at home (e.g., blood or urine tests, injections, etc.)
  • 08: Moving around inside residence
  • 09: None of the above

HELP RECEIVED (HRE) - Question identifier:HRE_Q10

Because of your condition, do you need more help than you usually receive with any of the following activities?

  • 01: Preparing meals
  • 02: Everyday housework (e.g., dusting or tidying up)
  • 03: Heavy household chores (e.g., yard work, snow removal or spring cleaning)
  • 04: Getting to appointments or running errands (e.g., shopping for groceries or other essential items)
  • 05: Looking after personal finances (e.g., making bank transactions or paying bills)
  • 06: Personal care (e.g., washing, dressing or taking medication)
  • 07: Basic medical care at home (e.g., blood or urine tests, injections, etc.)
  • 08: Moving around inside residence
  • 09: None of the above

HELP RECEIVED (HRE) - Question identifier:HRE_Q15

Because of your condition, do you need help with any of the following activities?

  • 01: Preparing meals
  • 02: Everyday housework (e.g., dusting or tidying up)
  • 03: Heavy household chores (e.g., yard work, snow removal or spring cleaning)
  • 04: Getting to appointments or running errands (e.g., shopping for groceries or other essential items)
  • 05: Looking after personal finances (e.g., making bank transactions or paying bills)
  • 06: Personal care (e.g., washing, dressing or taking medication)
  • 07: Basic medical care at home (e.g., blood or urine tests, injections, etc.)
  • 08: Moving around inside residence
  • 09: None of the above

HELP RECEIVED (HRE) - Question identifier:HRE_Q20

Thinking of all the help you receive with your activities because of your condition, how often do you usually receive help?

  • 1: Daily
  • 2: At least once a week
  • 3: At least once a month
  • 4: Less than once a month

HELP RECEIVED (HRE) - Question identifier:HRE_Q25

Who helps you with your activities?

  • 1: Family member living with you
  • 2: Family member not living with you
  • 3: Friend or neighbour
  • 4: Organization or individual you pay
  • 5: Organization or individual you do not pay
  • 6: Other organization or individual

HELP RECEIVED (HRE) - Question identifier:HRE_Q30

Thinking of all the help you receive because of your condition, in the past 12 months, did you have any expenses for help received, for which you will not be reimbursed?

  • 1: Yes
  • 2: No

HELP RECEIVED (HRE) - Question identifier:HRE_Q35

What is the amount of these expenses for which you will not be reimbursed?

  • 1: Less than $500
  • 2: $500 to less than $1,000
  • 3: $1,000 to less than $2,000
  • 4: $2,000 to less than $5,000
  • 5: $5,000 to less than $7,500
  • 6: $7,500 to less than $10,000
  • 7: $10,000 or more
  • 9: DK

HEALTH CARE SERVICES (HCS)

HEALTH CARE SERVICES (HCS) - Question identifier:HCS_R05

The next questions are about the contact you have with health care and social service providers because of any of your conditions.

HEALTH CARE SERVICES (HCS) - Question identifier:HCS_Q05

During the past 12 months, did you receive any of the following therapies or services on a regular basis because of your condition?

  • 01: Physiotherapy, massage therapy or chiropractic treatments
  • 02: Speech therapy
  • 03: Occupational therapy
  • 04: Counselling services from a psychologist, psychiatrist, psychotherapist or social worker
  • 05: Professional nursing care at home (e.g., injections, catheter or colostomy care, wound care or tube feeding)
  • 06: Support group services, drop-in center services or telephone information or support lines
  • 07: Addiction services
  • 08: Tutor
  • 09: Other therapy or service - specify:
  • 10: None

HEALTH CARE SERVICES (HCS) - Question identifier:HCS_Q10

During the past 12 months, did you need to receive more of the following therapies or services because of your condition?

  • 01: Physiotherapy, massage therapy or chiropractic treatments
  • 02: Speech therapy
  • 03: Occupational therapy
  • 04: Counselling services from a psychologist, psychiatrist, psychotherapist or social worker
  • 05: Professional nursing care at home (e.g., injections, catheter or colostomy care, wound care or tube feeding)
  • 06: Support group services, drop-in center services or telephone information or support lines
  • 07: Addiction services
  • 08: Tutor
  • 09: [HCS_Q05 Category 09 response/Other therapy or service]
  • 10: None

HEALTH CARE SERVICES (HCS) - Question identifier:HCS_Q15

During the past 12 months, which of the following therapies or services did you need on a regular basis because of your condition but did not receive?

  • 01: Physiotherapy, massage therapy or chiropractic treatments
  • 02: Speech therapy
  • 03: Occupational therapy
  • 04: Counselling services from a psychologist, psychiatrist, psychotherapist or social worker
  • 05: Professional nursing care at home (e.g., injections, catheter or colostomy care, wound care or tube feeding)
  • 06: Support group services, drop-in center services or telephone information or support lines
  • 07: Addiction services
  • 08: Tutor
  • 09: Other therapy or service - specify:
  • 10: None

EDUCATION (EDU)

EDUCATION (EDU) - Question identifier:EDU_R05

The next questions are on education.

EDUCATION (EDU) - Question identifier:EDU_Q05

Are you currently attending school, college, CEGEP or university?

  • 1: Yes
  • 2: No

EDUCATION (EDU) - Question identifier:EDU_Q10

When did you last attend school, college, CEGEP or university?

  • 1: 2016 or 2017
  • 2: Between 2012 and 2015
  • 3: Before 2012
  • 4: Never
  • 9: DK

EDUCATION (EDU) - Question identifier:EDU_Q15

Did you have your condition when you were attending school?

  • 1: Yes
  • 2: No

EDUCATION (EDU) - Question identifier:EDU_Q20

What type of educational institution [are you attending/did you attend]?

  • 1: Elementary, junior high school or high school
  • 2: Trade school, business school, community college, technical institute, CEGEP or other non-university institution
  • 3: University

EDUCATION (EDU) - Question identifier:EDU_Q25

[Are/Were] you enrolled as

  • 1: a full-time student
  • 2: a part-time student
  • 3: both full-time and part-time student

EDUCATION (EDU) - Question identifier:EDU_Q30

[Are/Were] you studying part-time because of your condition?

  • 1: Yes
  • 2: No

EDUCATION (EDU) - Question identifier:EDU_Q35

Because of your condition, [do/did] you require adapted or modified building features to attend school?

  • 1: Yes
  • 2: No

EDUCATION (EDU) - Question identifier:EDU_Q40

[Do/Did] you require

  • 1: accessible classrooms
  • 2: adapted washrooms
  • 3: accessible residences
  • 4: accessible buildings, excluding residences
  • 5: another feature - specify:
  • 6: None of the above

EDUCATION (EDU) - Question identifier:EDU_Q45

Which of the following features were made available to you?

  • 1: Accessible classrooms
  • 2: Adapted washrooms
  • 3: Accessible residences
  • 4: Accessible buildings, excluding residences
  • 5: [EDU_Q40 Category 5 response/Other features]
  • 6: None of the above

EDUCATION (EDU) - Question identifier:EDU_Q50

[Do/Did] you require specialized transportation to attend school?

  • 1: Yes
  • 2: No

EDUCATION (EDU) - Question identifier:EDU_Q55

[Is/Was] specialized transportation available to you?

  • 1: Yes
  • 2: No

EDUCATION (EDU) - Question identifier:EDU_Q60

[Do/Did] you need any assistive devices, support services, modification to curriculum or additional time for testing to follow your courses?

  • 1: Yes
  • 2: No

EDUCATION (EDU) - Question identifier:EDU_Q65

[Do/Did] you need

  • 01: a cell phone, smartphone or smartwatch with specialized features to help with your condition
  • 02: a computer, laptop or tablet with specialized software or other adaptations to help with your condition
  • 03: recording equipment or a portable note-taking device
  • 04: a device for playing audio books or e-books
  • 05: textbooks in e-format
  • 06: magnifiers
  • 07: closed-circuit devices (e.g., CCTV)
  • 08: large print reading materials
  • 09: Braille reading materials or a manual Brailler
  • 10: a teacher's aide or tutor
  • 11: a sign language interpreter
  • 12: attendant care services
  • 13: a speech therapist
  • 14: special education classes
  • 15: a modified or adapted course curriculum
  • 16: an Individualized Education Plan (e.g., IEP, PLP)
  • 17: extended time to take tests and exams
  • 18: another aid or service - specify:
  • 19: None of the above

EDUCATION (EDU) - Question identifier:EDU_Q70

Which of the following were made available to you?

  • 01: Cell phone, smartphone or smartwatch with specialized features to help with your condition
  • 02: Computer, laptop or tablet with specialized software or other adaptations to help with your condition
  • 03: Recording equipment or a portable note-taking device
  • 04: Device for playing audio books or e-books
  • 05: Textbooks in e-format
  • 06: Magnifiers
  • 07: Closed-circuit devices (e.g., CCTV)
  • 08: Large print reading materials
  • 09: Braille reading materials or manual brailler
  • 10: Teacher's aide or tutor
  • 11: Sign language interpreter
  • 12: Attendant care services
  • 13: Speech therapist
  • 14: Special education classes
  • 15: Modified or adapted course curriculum
  • 16: Individualized Education Plan (e.g., IEP, PLP)
  • 17: Extended time to take tests and exams
  • 18: [EDU_Q65 Category 18 response/Other aid or service]
  • 19: None of the above

EDUCATIONAL EXPERIENCES (EEX)

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_R05

Now some questions about your experience at school.

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q05

[Have you ever discontinued/Did you discontinue] your formal education or training due to the lack of assistive devices or support services?

  • 1: Yes
  • 2: No

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q10

[Have you ever discontinued/Did you discontinue] your formal education or training because of your condition?

  • 1: Yes
  • 2: No

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_R15

Because of your condition

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q15A

A. did you begin school later than most other people your age

  • 1: Yes
  • 2: No

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q15B

B. did you take any courses by correspondence, online or home study

  • 1: Yes
  • 2: No

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q15C

C. did you ever change schools

  • 1: Yes
  • 2: No

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q15D

D. did you have to leave your community to attend school

  • 1: Yes
  • 2: No

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q15E

E. did you ever attend a special education school or special education classes in a regular school

  • 1: Yes
  • 2: No

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q15F

F. did you take fewer courses or subjects than you otherwise would have

  • 1: Yes
  • 2: No

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q15G

G. did you ever change your course of studies

  • 1: Yes
  • 2: No

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q15H

H. was your choice of courses or careers influenced

  • 1: Yes
  • 2: No

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q15I

I. was your education interrupted for long periods of time

  • 1: Yes
  • 2: No

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q15J

J. did you ever go back to school for retraining

  • 1: Yes
  • 2: No

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q15K

K. did you have any additional expenses for your schooling

  • 1: Yes
  • 2: No

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q20A

Because of your condition, did it take you longer to achieve your present level of education?

  • 1: Yes
  • 2: No

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q20B

How much longer did it take?

Min = 0; Max = 10

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_R25

Because of your condition

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q25A

A. did some people avoid you at school

  • 1: Yes
  • 2: No

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q25B

B. did you feel left out of things at school

  • 1: Yes
  • 2: No

EDUCATIONAL EXPERIENCES (EEX) - Question identifier:EEX_Q25C

C. did you experience bullying at school

  • 1: Yes
  • 2: No

EDUCATIONAL BACKGROUND (EDB)

EDUCATIONAL BACKGROUND (EDB) - Question identifier:EDB_Q05

What is the highest certificate, diploma or degree that you have completed?

  • 1: Less than high school diploma or its equivalent
  • 2: High school diploma or a high school equivalency certificate
  • 3: Trade certificate or diploma
  • 4: College, CEGEP or other non-university certificate or diploma (Exclude trade certificates or diplomas)
  • 5: University certificate or diploma below the bachelor's level
  • 6: Bachelor's degree (e.g., B.A., B.Sc., B.Ed., LL.B.)
  • 7: University certificate, diploma or degree above the bachelor's level
  • 9: DK

EDUCATIONAL BACKGROUND (EDB) - Question identifier:EDB_Q10

In what year did you complete your highest certificate, diploma or degree?

Min = 1900; Max = 2017

EDUCATIONAL BACKGROUND (EDB) - Question identifier:EDB_Q15

What was the major field of study of the highest certificate, diploma or degree you completed?

Long Answer Length = 80

LABOUR MARKET ACTIVITIES MINIMAL (LMAM)

LABOUR MARKET ACTIVITIES MINIMAL (LMAM) - Question identifier:LMAM_R01

Many of the following questions concern your activities last week. Last week is the week beginning on Sunday and ending Saturday of last week.

LABOUR MARKET ACTIVITIES MINIMAL (LMAM) - Question identifier:LMAM_Q01

Last week, did you work at a job or business?

  • 1: Yes
  • 2: No
  • 3: Completely prevented from working

LABOUR MARKET ACTIVITIES MINIMAL (LMAM) - Question identifier:LMAM_Q02

Last week, did you have a job or business from which you were absent?

  • 1: Yes
  • 2: No

LABOUR MARKET ACTIVITIES MINIMAL (LMAM) - Question identifier:LMAM_Q03

What was the main reason you were absent from work last week?

  • 01: Own illness or disability
  • 02: Caring for own children
  • 03: Caring for adult family member
  • 04: Maternity or parental leave
  • 05: Other personal or family responsibilities
  • 06: Vacation
  • 07: Labour dispute, strike or lockout
  • 08: Temporary layoff due to business conditions
  • 09: Seasonal layoff
  • 10: Casual job, no work available
  • 11: Work schedule (e.g., shift work)
  • 12: Self-employed, no work available
  • 13: Seasonal business (Include self-employed only)
  • 14: Other reason for being absent from work - specify:

LABOUR FORCE STATUS (LMA2)

LABOUR FORCE STATUS (LMA2) - Question identifier:LMA2_Q04

Did you do anything to find work during the past four weeks?

  • 1: Yes
  • 2: No

LABOUR FORCE STATUS (LMA2) - Question identifier:LMA2_Q05

Last week, did you have a job to start at a definite date in the future?

  • 1: Yes
  • 2: No

LABOUR FORCE STATUS (LMA2) - Question identifier:LMA2_Q06

Will you start that job in the next four weeks?

  • 1: Yes
  • 2: No

LABOUR FORCE STATUS (LMA2) - Question identifier:LMA2_Q07

How many hours do you want to work per week?

  • 1: 30 or more hours
  • 2: Less than 30 hours

LABOUR FORCE STATUS (LMA2) - Question identifier:LMA2_Q08

Last week could you have worked [if you had been recalled/if a suitable job had been offered]?

  • 1: Yes
  • 2: No

LABOUR FORCE STATUS (LMA2) - Question identifier:LMA2_Q09

What was the main reason you were not available to work last week?

  • 01: Own illness or disability
  • 02: Caring for own children
  • 03: Caring for an adult family member
  • 04: Other personal or family responsibilities
  • 05: Going to school
  • 06: Vacation
  • 07: Already has a job
  • 08: Other reason why you were not available for work last week - specify:

CLASS OF WORKER (LMA3)

CLASS OF WORKER (LMA3) - Question identifier:LMA3_R10

Now some questions about the job or business at which you usually work the most hours.

CLASS OF WORKER (LMA3) - Question identifier:LMA3_Q10

Were you an employee or self-employed?

  • 1: Employee
  • 2: Self-employed
  • 3: Working in a family business without pay

SELF-EMPLOYED (SEMP)

SELF-EMPLOYED (SEMP) - Question identifier:SEMP_Q05

What is the main reason you became self-employed instead of working for an employer?

Long Answer Length = 80

JOB TENURE (JT)

JOB TENURE (JT) - Question identifier:JT_Q05

In which year did you start working for the employer you had last week?

Min = 1950; Max = 2017

JOB TENURE (JT) - Question identifier:JT_Q10

In which month did you start working for the employer you had last week?

  • 01: January
  • 02: February
  • 03: March
  • 04: April
  • 05: May
  • 06: June
  • 07: July
  • 08: August
  • 09: September
  • 10: October
  • 11: November
  • 12: December
  • 99: DK

JOB TENURE (JT) - Question identifier:JT_Q15

In which year did you start working at your business?

Min = 1950; Max = 2017

JOB TENURE (JT) - Question identifier:JT_Q20

In which month did you start working at your business?

  • 01: January
  • 02: February
  • 03: March
  • 04: April
  • 05: May
  • 06: June
  • 07: July
  • 08: August
  • 09: September
  • 10: October
  • 11: November
  • 12: December
  • 99: DK

INDUSTRY (LMA4)

INDUSTRY (LMA4) - Question identifier:LMA4_Q11

What was the name of your business?

Long Answer Length = 50

INDUSTRY (LMA4) - Question identifier:LMA4_Q12

Last week, for whom did you work?

Long Answer Length = 50

INDUSTRY (LMA4) - Question identifier:LMA4_Q13

What kind of business, industry or service was this?

Long Answer Length = 50

OCCUPATION (LMA5)

OCCUPATION (LMA5) - Question identifier:LMA5_Q14

What was your work or occupation?

Long Answer Length = 50

OCCUPATION (LMA5) - Question identifier:LMA5_Q15

In this work, what were your main activities?

Long Answer Length = 50

WORKPLACE (WKPL)

WORKPLACE (WKPL) - Question identifier:WKPL_Q05

In this job, are you a union member or covered by a union contract or collective agreement?

  • 1: Yes
  • 2: No

WORKPLACE (WKPL) - Question identifier:WKPL_Q10

About how many persons are employed at the location where you now work?

  • 1: Less than 20
  • 2: 20 to 99
  • 3: 100 to 500
  • 4: Over 500
  • 9: DK

USUAL HOURS OF WORK (LMA6)

USUAL HOURS OF WORK (LMA6) - Question identifier:LMA6_Q16

[Excluding overtime, on average, how many paid hours do you usually work per week/On average, how many hours do you usually work per week]?

Min = 0.0; Max = 168.0

PART-TIME EMPLOYMENT (PT)

PART-TIME EMPLOYMENT (PT) - Question identifier:PT_Q05

What is the main reason you usually work less than 30 hours per week?

  • 01: Temporary illness
  • 02: Health condition
  • 03: Caring for own children
  • 04: Caring for an adult family member
  • 05: Other personal or family responsibilities
  • 06: Going to school
  • 07: Economic conditions
  • 08: Could not find work with 30 or more hours per week
  • 09: Job is part-time or contract / More hours not available
  • 10: Personal preference (e.g., do not want to work more than 30 hours)
  • 11: Other reason for working less than 30 hours per week - specify:

PERMANENT WORK (PW)

PERMANENT WORK (PW) - Question identifier:PW_Q05

Is your job permanent, or is there some way that it is not permanent?

  • 1: Permanent
  • 2: Not permanent ( e.g., seasonal, temporary, term, casual)

PERMANENT WORK (PW) - Question identifier:PW_Q10

In what way is your job not permanent?

  • 1: Seasonal job
  • 2: Temporary, term or contract job (e.g., non-seasonal)
  • 3: Casual job
  • 4: Work done through a temporary help agency
  • 5: Student job
  • 6: Apprenticeship, internship or articling position
  • 7: Other reason why job is not permament - specify:

PERIODS OF UNEMPLOYMENT (POU)

PERIODS OF UNEMPLOYMENT (POU) - Question identifier:POU_Q05

Have you had any periods of unemployment in the past five years?

  • 1: Yes
  • 2: No

PERIODS OF UNEMPLOYMENT (POU) - Question identifier:POU_Q10

How many different periods of unemployment did you have?

  • 1: One
  • 2: Two
  • 3: Three or more
  • 9: DK

EMPLOYMENT DETAILS (EDE)

EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q05

Because of your condition, have you ever

  • 1: changed the kind of work you do
  • 2: changed the amount of work you do
  • 3: changed jobs
  • 4: began working from home
  • 5: taken an absence from work of one month or more
  • 6: None of the above

EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q10

Does your condition limit the amount or kind of work you can do at your present job or business?

  • 1: Yes
  • 2: No

EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q15

Where were you employed when you first experienced work limitations?

  • 1: Working with current employer or business
  • 2: Working elsewhere
  • 3: Not working

EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q20

Are you now doing the same kind of work as you were doing at the time you first experienced work limitations?

  • 1: Yes
  • 2: No

EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q25

Is your condition the reason you are now doing a different kind of work?

  • 1: Yes
  • 2: No

EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q30

Do you believe that your condition makes it difficult for you to change jobs or to advance at your present job?

  • 1: Yes, very difficult
  • 2: Yes, difficult
  • 3: No, not difficult

EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q35

Why do you believe that your condition makes it difficult for you to change jobs or advance at your present job or business?

  • 1: Discrimination or stigma because of condition
  • 2: Condition limits number of hours that can be worked
  • 3: Condition limits ability to search for a job
  • 4: Difficult to obtain required supports or accommodations
  • 5: Adapting to a new work environment would be difficult
  • 6: Other reason
  • 7: None of the above

EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q40

Have you told your employer about your condition?

  • 1: Yes
  • 2: No

EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q45

Does your work give you the opportunity to use all your education, skills or work experience?

  • 1: Yes
  • 2: No

EMPLOYMENT DETAILS (EDE) - Question identifier:EDE_Q50

Does your work require the level of education you have?

  • 1: Yes
  • 2: No

LOOKING FOR WORK (LW)

LOOKING FOR WORK (LW) - Question identifier:LW_Q05

What did you do to find work during the past four weeks?

  • 01: Contacted employers directly
  • 02: Looked at job ads
  • 03: Placed or answered job ads
  • 04: Contacted a government employment agency (e.g., Service Canada or a provincial/territorial employment centre)
  • 05: Contacted a private employment agency
  • 06: Contacted a union
  • 07: Contacted friends or relatives
  • 08: Other method to find work - specify:

LOOKING FOR WORK (LW) - Question identifier:LW_Q10

As of last week, how many weeks have you been looking for work?

Min = 0; Max = 999

LOOKING FOR WORK (LW) - Question identifier:LW_Q15

In what kind of business, industry or service were you looking for work?

Long Answer Length = 80

LOOKING FOR WORK (LW) - Question identifier:LW_R20

Have any of the following caused you difficulty in finding work?

LOOKING FOR WORK (LW) - Question identifier:LW_Q20A

A. Not knowing how or where to look for work

  • 1: Yes
  • 2: No

LOOKING FOR WORK (LW) - Question identifier:LW_Q20B

B. Not knowing the type of job you wanted

  • 1: Yes
  • 2: No

LOOKING FOR WORK (LW) - Question identifier:LW_Q20C

C. Not having the work experience required for available jobs

  • 1: Yes
  • 2: No

LOOKING FOR WORK (LW) - Question identifier:LW_Q20D

D. Not having enough education or training for available jobs

  • 1: Yes
  • 2: No

LOOKING FOR WORK (LW) - Question identifier:LW_Q20E

E. Not having the means of transportation to get to available jobs

  • 1: Yes
  • 2: No

LOOKING FOR WORK (LW) - Question identifier:LW_Q20F

F. A shortage of jobs

  • 1: Yes
  • 2: No

LOOKING FOR WORK (LW) - Question identifier:LW_Q25A

Is there anything else that has caused you difficulty in finding work?

  • 1: Yes
  • 2: No

LOOKING FOR WORK (LW) - Question identifier:LW_Q25B

What has made it difficult for you to find work?

Long Answer Length = 80

PAST JOB ATTACHMENT (PJA)

PAST JOB ATTACHMENT (PJA) - Question identifier:PJA_Q05

Have you ever worked at a job or business?

  • 1: Yes
  • 2: No

PAST JOB ATTACHMENT (PJA) - Question identifier:PJA_Q10

When did you last work?

Min = 1900; Max = 2017

PAST JOB ATTACHMENT (PJA) - Question identifier:PJA_Q15

In which month did you last work?

  • 01: January
  • 02: February
  • 03: March
  • 04: April
  • 05: May
  • 06: June
  • 07: July
  • 08: August
  • 09: September
  • 10: October
  • 11: November
  • 12: December
  • 99: DK

CLASSIFICATION OF RETIREMENT (RETC)

CLASSIFICATION OF RETIREMENT (RETC) - Question identifier:RETC_Q05

At this time, do you consider yourself to be

  • 1: completely retired
  • 2: partly retired
  • 3: not retired

CLASSIFICATION OF RETIREMENT (RETC) - Question identifier:RETC_Q10

Have you ever retired from a job?

  • 1: Yes
  • 2: No

CLASSIFICATION OF RETIREMENT (RETC) - Question identifier:RETC_Q15

After retirement, some people return to work and later retire again. Have you retired more than one time?

  • 1: Yes
  • 2: No

CLASSIFICATION OF RETIREMENT (RETC) - Question identifier:RETC_Q20

When did you [last/blank] retire?

Min = 1900; Max = 2017

RETIREMENT DETAILS (RDE)

RETIREMENT DETAILS (RDE) - Question identifier:RDE_Q05

Did you retire because of your condition?

  • 1: Yes, completely
  • 2: Yes, partially
  • 3: No

RETIREMENT DETAILS (RDE) - Question identifier:RDE_Q10

In [year], did you retire from a job or business or did you stop looking for work?

  • 1: Retired from job or business
  • 2: Stopped looking for work

RETIREMENT DETAILS (RDE) - Question identifier:RDE_Q15

Was this retirement voluntary?

  • 1: Yes
  • 2: No

UNEMPLOYED DETAILS (UDE)

UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q05

When you last worked, how many hours did you usually work per week?

Min = 1; Max = 168

UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q10

Were you an employee or self-employed?

  • 1: Employee
  • 2: Self-employed
  • 3: Working in a family business without pay

UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q15

What was the name of your business?

Long Answer Length = 50

UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q20

For whom did you work?

Long Answer Length = 50

UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q25

What kind of business, industry or service was this?

Long Answer Length = 50

UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q30

What was your work or occupation?

Long Answer Length = 50

UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q35

In this work, what were your main activities?

Long Answer Length = 50

UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q40

Does your condition limit the amount or kind of work you can do at a job or business?

  • 1: Yes
  • 2: No

UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q45

Were you working at a job or business at the time you became limited in the kind or amount of work you can do?

  • 1: Yes
  • 2: No

UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q50

Does your condition affect your ability to look for work?

  • 1: Yes
  • 2: No

UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q55

Because of your condition, are you limited in your ability to

  • 1: work at a full-time job
  • 2: work at a part-time job
  • 3: Neither

UNEMPLOYED DETAILS (UDE) - Question identifier:UDE_Q60

Did you tell your previous employer about your condition?

  • 1: Yes
  • 2: No

NOT IN THE LABOUR FORCE DETAILS (NDE)

NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q05

When you last worked, how many hours did you usually work per week?

Min = 1; Max = 168

NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q10

Were you an employee or self-employed?

  • 1: Employee
  • 2: Self-employed
  • 3: Working in a family business without pay

NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q15

What was the name of your business?

Long Answer Length = 50

NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q20

For whom did you work?

Long Answer Length = 50

NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q25

What kind of business, industry or service was this?

Long Answer Length = 50

NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q30

What was your work or occupation?

Long Answer Length = 50

NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q35

In this work, what were your main activities?

Long Answer Length = 50

NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q40

Does your condition completely prevent you from working at a job or business?

  • 1: Yes
  • 2: No

NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q45

Is there some type of workplace arrangement or modification that would enable you to work at a paid job or business such as modified or different duties or technical aids?

  • 1: Yes
  • 2: No

NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q50

Does your condition limit the amount or kind of work you could do at a job or business?

  • 1: Yes
  • 2: No

NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q55

Were you working at a job or business at the time you became [completely unable to work/limited in the amount or kind of work you could do]?

  • 1: Yes
  • 2: No

NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q60

Does your condition affect your ability to look for work?

  • 1: Yes
  • 2: No

NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q65

Have you looked for work in the past two years?

  • 1: Yes
  • 2: No

NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q70

Some people have encountered barriers which have discouraged them from looking for work. Thinking about your own experience, indicate which of the following situations might apply to you.

  • 01: [Your] expected employment income would be less than your current income
  • 02: [You] would lose additional supports (e.g., drug plan or housing)
  • 03: Lack of specialized transportation
  • 04: Family responsibilities prevent you from working
  • 05: Past attempts to find work have been unsuccessful
  • 06: Family or friends discourage you from working
  • 07: [You] have experienced discrimination in the past
  • 08: [You] feel your training or experience is not adequate for the current job market
  • 09: Few jobs available in the local area
  • 10: [You] experienced accessibility issues when applying for work
  • 11: Other barrier - specify:
  • 12: None

NOT IN THE LABOUR FORCE DETAILS (NDE) - Question identifier:NDE_Q75

Did you tell your previous employer about your condition?

  • 1: Yes
  • 2: No
  • 9: DK

LABOUR MARKET ATTACHMENT (LA)

LABOUR MARKET ATTACHMENT (LA) - Question identifier:LA_Q05

Did you want a job last week?

  • 1: Yes
  • 2: No

LABOUR MARKET ATTACHMENT (LA) - Question identifier:LA_Q10

What was the main reason you did not look for work last week?

  • 01: Temporary illness
  • 02: Health condition
  • 03: Caring for own children
  • 04: Caring for an adult family member
  • 05: Other personal or family responsibilities
  • 06: Going to school
  • 07: Waiting for recall to former job
  • 08: Waiting for replies from employers
  • 09: Believed no work is available in the area
  • 10: Believed no work is available suited to skills
  • 11: Fear of prejudice or discrimination
  • 12: No reason
  • 13: Other reason for not looking for work

LABOUR MARKET ATTACHMENT (LA) - Question identifier:LA_Q15

Could you have worked last week if a suitable job had been offered?

  • 1: Yes
  • 2: No

LABOUR MARKET ATTACHMENT (LA) - Question identifier:LA_Q20

What was the main reason you were not available to work last week?

  • 01: Temporary illness
  • 02: Health condition
  • 03: Caring for own children
  • 04: Caring for an adult family member
  • 05: Other personal or family responsibilities
  • 06: Going to school
  • 07: Vacation
  • 08: Already have a job
  • 09: Other main reason for not being available for work last week - specify:

LABOUR MARKET ATTACHMENT (LA) - Question identifier:LA_Q25

Do you think that you will look for work any time in the next 12 months?

  • 1: Yes
  • 2: No

LABOUR MARKET ATTACHMENT (LA) - Question identifier:LA_Q30

Why do you think that you will look for work any time in the next 12 months?

  • 1: [You] expect your condition to improve
  • 2: There will be changes or improvements in the workplace
  • 3: [You] will be taking training
  • 4: Another reason
  • 5: No reason

PERIODS OF EMPLOYMENT (POE)

PERIODS OF EMPLOYMENT (POE) - Question identifier:POE_Q05

Have you had any periods of employment in the last 12 months; that is to say, periods when you had a job or business?

  • 1: Yes
  • 2: No

PERIODS OF EMPLOYMENT (POE) - Question identifier:POE_Q10

How many different periods of employment did you have?

  • 1: One
  • 2: Two
  • 3: Three or more

PERIODS OF EMPLOYMENT (POE) - Question identifier:POE_Q15

What was the length of the longest period of employment?

  • 1: Under three months
  • 2: Three to five months
  • 3: Six months or more

LABOUR MOBILITY (LM)

LABOUR MOBILITY (LM) - Question identifier:LM_Q05

Would you be able to move to another city, town or community to improve your job or career opportunities?

  • 1: Yes
  • 2: No
  • 3: Maybe

LABOUR MOBILITY (LM) - Question identifier:LM_Q10

What are the reasons you could not move?

  • 01: Still in school
  • 02: Satisfied with current job situation
  • 03: Need the support of local family and friends
  • 04: Caring for own children
  • 05: Other family responsibilities
  • 06: Health condition
  • 07: Prefer current location
  • 08: Provincial health insurance coverage or benefits
  • 09: Transportation or transit
  • 10: Retired
  • 11: Other main reason for not moving - specify:
  • 12: No Reason

WORKPLACE TRAINING (WTR)

WORKPLACE TRAINING (WTR) - Question identifier:WTR_R05

The next few questions deal with job-related training paid for or provided by your employer or company.

WORKPLACE TRAINING (WTR) - Question identifier:WTR_Q05

In the past 12 months, have you received any classroom training related to your job?

  • 1: Yes
  • 2: No

WORKPLACE TRAINING (WTR) - Question identifier:WTR_Q10

During the last 12 months of your previous employment, did you receive any classroom training related to your job?

  • 1: Yes
  • 2: No

WORKPLACE TRAINING (WTR) - Question identifier:WTR_Q15

In the past 12 months, have you received any on-the-job training?

  • 1: Yes
  • 2: No

WORKPLACE TRAINING (WTR) - Question identifier:WTR_Q20

During the last 12 months of your previous employment, did you receive any on-the-job training?

  • 1: Yes
  • 2: No

WORKPLACE TRAINING (WTR) - Question identifier:WTR_Q25

In the past 12 months, did you participate in any work-related training that was not paid for or provided by an employer?

  • 1: Yes
  • 2: No

WORKPLACE TRAINING (WTR) - Question identifier:WTR_Q30

Who paid for this training?

  • 1: Paid for it yourself
  • 2: Provided by government program
  • 3: Provided by non-profit organization or other agency for free
  • 4: Other
  • 9: DK

WORKPLACE TRAINING (WTR) - Question identifier:WTR_Q35

In the past 12 months, did you want to take some work-related training courses?

  • 1: Yes
  • 2: No
  • 9: DK

WORKPLACE TRAINING (WTR) - Question identifier:WTR_Q40

Did any of the following prevent you from taking any work-related training courses?

  • 01: Location was not physically accessible
  • 02: Courses were not adapted to the needs of your condition
  • 03: [You] requested courses but were denied them by employer
  • 04: [Your] condition
  • 05: Inadequate transportation
  • 06: Too costly
  • 07: Too busy
  • 08: Other reason
  • 99: DK

WORKPLACE TRAINING (WTR) - Question identifier:WTR_Q45

Why did you not want to take any work-related training courses?

  • 01: Location was not physically accessible
  • 02: Courses were not adapted to the needs of your condition
  • 03: [You] requested courses but were denied them by employer
  • 04: [Your] condition
  • 05: Inadequate transportation
  • 06: Too costly
  • 07: Too busy
  • 08: Other reason
  • 09: No reason

EMPLOYMENT MODIFICATIONS (EMO)

EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q05

Because of your condition, [do/would] you require any of the following to be able to work?

  • 01: Modified or different duties
  • 02: Working from home
  • 03: Modified hours or days or reduced work hours
  • 04: Human support (e.g., reader, sign language interpreter, job coach or personal assistant)
  • 05: Technical aids (e.g., voice synthesizer, TTY, infrared system or portable note-taker)
  • 06: Computer, laptop or tablet with specialized software or other adaptations (e.g., Braille, screen magnification software, voice recognition software or a screen reader)
  • 07: Communication aids (e.g., Braille or large print reading material or recording equipment)
  • 08: Modified or ergonomic workstation
  • 09: Special chair or back support
  • 10: Handrails, ramps, widened doorways or hallways
  • 11: Adapted or accessible parking
  • 12: Accessible elevators
  • 13: Adapted washrooms
  • 14: Specialized transportation
  • 15: Other equipment, help or work arrangement - specify:
  • 16: None of the above

EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q10

Which of the following have been made available to you?

  • 01: Modified or different duties
  • 02: Working from home
  • 03: Modified hours or days or reduced work hours
  • 04: Human support (e.g., reader, sign language interpreter, job coach or personal assistant)
  • 05: Technical aids (e.g., voice synthesizer, TTY, infrared system or portable note-taker)
  • 06: Computer, laptop or tablet with specialized software or other adaptations (e.g., Braille, screen magnification software, voice recognition software or screen reader)
  • 07: Communication aids (e.g., Braille or large print reading material or recording equipment)
  • 08: Modified or ergonomic workstation
  • 09: Special chair or back support
  • 10: Handrails, ramps, widened doorways or hallways
  • 11: Adapted or accessible parking
  • 12: Accessible elevators
  • 13: Adapted washrooms
  • 14: Specialized transportation
  • 15: [EMO_Q05 Category 15 response/Other equipment, help or work arrangement]
  • 16: None of the above

EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q15

Did you ask your employer for the workplace accommodations that have not been made available to you?

  • 1: Yes
  • 2: No

EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q20

Why have you not received the workplace accommodations that you need?

  • 1: Too expensive ( e.g., purchase, maintenance or repair)
  • 2: Employer or supervisor refused request
  • 3: On a waiting list
  • 4: Not available locally
  • 5: Other reason - specify:

EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q25

Is your employer aware that you need the workplace accommodations?

  • 1: Yes
  • 2: No
  • 9: DK

EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q30

Why have you not asked for the workplace accommodations needed?

  • 01: Uncomfortable asking
  • 02: Did not want to cause difficulty for employer
  • 03: Did not think employer could afford or find proper accommodations
  • 04: Did not want to disclose the need for accommodation
  • 05: Concerned about reaction of co-workers
  • 06: Fear of negative outcomes
  • 07: Condition is not severe enough
  • 08: Lack of awareness or understanding by employer with respect to accommodation requests
  • 09: Other reason - specify:

EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q35

Did you ask your previous employer for the work place accommodations that have not been made available?

  • 1: Yes
  • 2: No

EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q40

Why did you not receive the workplace accommodations needed?

  • 1: Too expensive ( e.g., purchase, maintenance or repair)
  • 2: Employer or supervisor refused request
  • 3: On a waiting list
  • 4: Not available locally
  • 5: Other reason - specify:

EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q45

Was your previous employer aware that you needed the workplace accommodations?

  • 1: Yes
  • 2: No
  • 9: DK

EMPLOYMENT MODIFICATIONS (EMO) - Question identifier:EMO_Q50

Why did you not ask for the workplace accommodations needed?

  • 01: Uncomfortable asking
  • 02: Did not want to cause difficulty for employer
  • 03: Did not think employer could afford or find proper accommodations
  • 04: Did not want to disclose the need for accommodation
  • 05: Concerned about reaction of co-workers
  • 06: Fear of negative outcomes
  • 07: Condition is not severe enough
  • 08: Lack of awareness or understanding by employer with respect to accommodation requests
  • 09: Other reason - specify:

LABOUR FORCE DISCRIMINATION (LFD)

LABOUR FORCE DISCRIMINATION (LFD) - Question identifier:LFD_Q05

In the past five years, do you believe that because of your condition, you have been refused a job interview?

  • 1: Yes
  • 2: No

LABOUR FORCE DISCRIMINATION (LFD) - Question identifier:LFD_Q10

In the past five years, do you believe that because of your condition, you have been refused a job?

  • 1: Yes
  • 2: No

LABOUR FORCE DISCRIMINATION (LFD) - Question identifier:LFD_Q15

In the past five years, do you believe that because of your condition, you have been refused a job promotion?

  • 1: Yes
  • 2: No

LABOUR FORCE DISCRIMINATION (LFD) - Question identifier:LFD_Q20

Do you consider yourself to be disadvantaged in employment because of your condition?

  • 1: Yes
  • 2: No

LABOUR FORCE DISCRIMINATION (LFD) - Question identifier:LFD_Q25

Do you believe that your current employer or any potential employer would be likely to consider you disadvantaged in employment because of your condition?

  • 1: Yes
  • 2: No

GENERAL HEALTH (GH)

GENERAL HEALTH (GH) - Question identifier:GH_R05

Now, some questions about your health. By health, we mean not only the absence of disease or injury but also physical, mental and social well-being.

GENERAL HEALTH (GH) - Question identifier:GH_Q05

In general, would you say your health is

  • 1: excellent
  • 2: very good
  • 3: good
  • 4: fair
  • 5: poor

GENERAL HEALTH (GH) - Question identifier:GH_Q10

Using a scale of 0 to 10, where 0 means "Very dissatisfied" and 10 means "Very satisfied", how do you feel about your life as a whole right now?

  • 01: 0 Very dissatisfied
  • 02: 1
  • 03: 2
  • 04: 3
  • 05: 4
  • 06: 5
  • 07: 6
  • 08: 7
  • 09: 8
  • 10: 9
  • 11: 10 Very satisfied

GENERAL HEALTH (GH) - Question identifier:GH_Q15

In general, would you say your mental health is

  • 1: excellent
  • 2: very good
  • 3: good
  • 4: fair
  • 5: poor

HOUSEBOUND (HB)

HOUSEBOUND (HB) - Question identifier:HB_Q05

Do you consider yourself housebound?

  • 1: Yes
  • 2: No

HOUSEBOUND (HB) - Question identifier:HB_Q10

What are the reasons you consider yourself housebound?

  • 1: Accessible transportation is not available to you
  • 2: You do not feel safe when you leave your home
  • 3: No attendant or companion is available to help you
  • 4: Your condition or health problem is aggravated when you go out
  • 5: Your social connections outside the home are limited
  • 6: Other reason you consider yourself housebound - specify:

VETERANS (VAC)

VETERANS (VAC) - Question identifier:VAC_Q05

Have you ever had any Canadian military service?

  • 1: Yes
  • 2: No

VETERANS (VAC) - Question identifier:VAC_Q10

Are you currently a member of the Canadian Armed Forces?

  • 1: Yes
  • 2: No

VETERANS (VAC) - Question identifier:VAC_Q15

In what year did you release from the Canadian Armed Forces?

Min = 1900; Max = 2017

INTERNET USE (IU)

INTERNET USE (IU) - Question identifier:IU_R05

Now some questions about the use of the Internet.

INTERNET USE (IU) - Question identifier:IU_Q05

How often do you use the Internet in a typical month?

  • 1: Daily
  • 2: A few times a week
  • 3: Once a week
  • 4: At least once a month
  • 5: Less than once a month
  • 6: Never

INTERNET USE (IU) - Question identifier:IU_Q10

What are the reasons you do not use the Internet?

  • 01: No need or no interest
  • 02: Lack of confidence or skills
  • 03: Cost (e.g., cost of service, equipment or repair)
  • 04: No Internet-ready device available in dwelling (e.g., desktop, laptop or tablet computer)
  • 05: No Internet service available in the area
  • 06: Require specialized adaptations or software
  • 07: Too many websites are inaccessible
  • 08: Security or privacy concerns (e.g., concerns about viruses, spyware or the use of personal information)
  • 09: Other reason - specify:

INTERNET USE (IU) - Question identifier:IU_Q15

During the past 12 months, did you use the Internet from

  • 1: home
  • 2: personal smart phone, tablet or other wireless handheld device
  • 3: another person's home
  • 4: work
  • 5: school or training institute
  • 6: some other location (e.g., public Wi-Fi, library, community center, etc.)

INTERNET USE (IU) - Question identifier:IU_Q20

During the past 12 months, have you used the Internet to

  • 1: communicate by e-mail or search for information
  • 2: use social networking websites (e.g., Facebook, Twitter, Instagram, etc.)
  • 3: access government services
  • 4: search for employment
  • 5: conduct electronic banking transactions (e.g., paying bills, viewing statements, etc.)
  • 6: purchase goods or services

INTERNET USE (IU) - Question identifier:IU_Q25

Because of your condition, do you need some type of specialized software or other adaptation to access the Internet?

  • 1: Yes
  • 2: No

INTERNET USE (IU) - Question identifier:IU_Q30

Do you have all of the specialized software or adaptations that you need?

  • 1: Yes
  • 2: No

INTERNET USE (IU) - Question identifier:IU_Q35

Why do you not have the specialized software or adaptations that you need?

  • 1: Cost
  • 2: Have trouble finding what is needed
  • 3: Would need help or training
  • 4: Not interested in the Internet
  • 5: Some other reason

ACCESSIBILITY OF GOVERNMENT SERVICES (AGS)

ACCESSIBILITY OF GOVERNMENT SERVICES (AGS) - Question identifier:AGS_R05A

Now some questions about accessing government services.

ACCESSIBILITY OF GOVERNMENT SERVICES (AGS) - Question identifier:AGS_Q05A

Which of the following ways of accessing government services would be difficult for you because of your condition?

  • 1: By phone
  • 2: By mail or fax
  • 3: In person
  • 4: By Internet
  • 5: None of the above

ACCESSIBILITY OF GOVERNMENT SERVICES (AGS) - Question identifier:AGS_Q05B

What aspect of accessing government services by phone would be difficult for you because of your condition?

Long Answer Length = 80

ACCESSIBILITY OF GOVERNMENT SERVICES (AGS) - Question identifier:AGS_Q05C

What aspect of accessing government services by mail or fax would be difficult for you because of your condition?

Long Answer Length = 80

ACCESSIBILITY OF GOVERNMENT SERVICES (AGS) - Question identifier:AGS_Q05D

What aspect of accessing government services in person would be difficult for you because of your condition?

Long Answer Length = 80

ACCESSIBILITY OF GOVERNMENT SERVICES (AGS) - Question identifier:AGS_Q05E

What aspect of accessing government services by Internet would be difficult for you because of your condition?

Long Answer Length = 80

ACCESSIBILITY OF GOVERNMENT SERVICES (AGS) - Question identifier:AGS_Q10

Which of the following ways of accessing government services would be your preferred method of contact?

  • 1: By phone
  • 2: By mail or fax
  • 3: In person
  • 4: By Internet
  • 5: None of the above

SOURCES OF INCOME (SNC)

SOURCES OF INCOME (SNC) - Question identifier:SNC_R05A

Now a question about personal income sources.

SOURCES OF INCOME (SNC) - Question identifier:SNC_Q05A

Did you receive income from any of the following sources for the year ending December 31, 2016?

  • 01: Employment (Include wages, salaries, commissions and tips)
  • 02: Self-employment (Include wages, salaries, commissions and tips)
  • 03: Workers' Compensation
  • 04: Employment Insurance or Quebec Parental Insurance Plan (Exclude Short-term disability sickness benefit)
  • 05: Pension plan benefits (Exclude disability benefits)
  • 06: Disability Benefits
  • 07: Social assistance or welfare (Exclude disability benefits)
  • 08: Other sources (e.g., other government income, child tax benefit, child support, education allowances and scholarships, Northern Allowance, spousal support, honoraria)
  • 09: No personal income source

SOURCES OF INCOME (SNC) - Question identifier:SNC_Q05B

Which of the following pension plan benefits did you receive?

  • 1: Canada or Quebec Pension Plan
  • 2: Old Age Security or Guaranteed Income Supplement
  • 3: Provincial or Territorial pension plan
  • 4: Private or employment related pension plan
  • 5: Other retirement pensions and annuities

SOURCES OF INCOME (SNC) - Question identifier:SNC_Q05C

Which of the following disability plan benefits did you receive?

  • 01: Canada or Quebec Pension Plan Disability
  • 02: Employment Insurance short-term disability sickness benefit (Include Quebec Parental Insurance disability benefits)
  • 03: Provincial or territorial disability programs (e.g., ODSP, DSP, AISH, PPMB)
  • 04: Private or employment related disability insurance plan
  • 05: Motor vehicle accident insurance disability
  • 06: Veterans Affairs Disability Pension
  • 07: Registered Disability Savings Plan
  • 08: Other disability plan benefits
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