Complete IRT CAT Items

ATTACHMENT 2

Complete List of Potential IRT-CAT Instrument Questions

Basic Mobility (45 items)

Response options:

  Yes, without difficulty
  Yes, with a little difficulty
  Yes, with some difficulty
  Yes, with a lot of difficulty
  Unable to do
  I don't know

ARE YOU ABLE TO WALK FROM STORE TO STORE WHILE SHOPPING ? FOR EXAMPLE IN A SHOPPING MALL.

ARE YOU ABLE WALK UP A FLIGHT OF STAIRS WITHOUT A HANDRAIL?

ARE YOU ABLE TO WALK TO THE BATHOOM?

ARE YOU ABLE TO STAND ON YOUR FEET FOR ONE HOUR?

ARE YOU ABLE TO WALK UP A STEEP SLOPE? FOR EXAMPLE ON A HILL.

ARE YOU ABLE TO WALK ON UNEVEN SURFACES? FOR EXAMPLE ON GRASS DIRT ROAD OR SIDEWALK.

ARE YOU ABLE TO WALK QUICKLY INDOORS? FOR EXAMPLE TO ANSWER THE TELEPHONE OR THE FRONT DOOR.

ARE YOU ABLE TO RUN A SHORT DISTANCE SUCH AS TO CATCH A BUS? A SHORT DISTANCE IS ROUGHLY HALF A BLOCK OR ABOUT 15-20 YARDS.

ARE YOU ABLE TO WALK AT LEAST 15 MINUTES?

ARE YOU ABLE TO WALK AROUND ONE FLOOR OF YOUR HOME WITHOUT TRIPPING OR LOSING YOUR BALANCE?

ARE YOU ABLE TO STAND IN THE SHOWER TO WASH YOUR HAIR?

ARE YOU ABLE TO GET IN AND OUT OF THE BATHTUB?

ARE YOU ABLE TO REACH INTO A CABINET FROM A STEP LADDER OR STOOL?

ARE YOU ABLE TO BEND DOWN TO USE A DUST PAN?

ARE YOU ABLE TO UNLOAD A WASHING MACHINE?

ARE YOU ABLE TO KNEEL DOWN TO TIE A SHOE?

ARE YOU ABLE TO BEND TO LOOK UNDER A CAR?

ARE YOU ABLE TO SIT IN A CAR FOR MORE THAN 2 HOURS?

ARE YOU ABLE TO CRAWL UNDER A TABLE TO PICK UP SOMETHING YOU DROPPED?

ARE YOU ABLE TO GET INTO AND OUT OF A CAR?
PLEASE BASE YOUR RESPONSE ON THE MOST DIFFICULT PART OF THIS ACTIVITY.

ARE YOU ABLE TO SIT ON A STOOL WITHOUT BACK SUPPORT?

ARE YOU ABLE TO GET UP OFF THE FLOOR FROM LYING ON YOUR BACK?
YOU CAN USE A CHAIR OR OTHER OBJECT TO GET UP.

ARE YOU ABLE TO GET IN AND OUT OF A SQUATTING POSITION? PLEASE BASE YOUR RESPONSE ON THE MOST DIFFICULT PART OF THE ACTIVITY.

ARE YOU ABLE TO CLIMB 2 OR 3 STEPS UP A STEP LADDER?

ARE YOU ABLE TO WORK AT FLOOR LEVEL? FOR EXAMPLE CHANGING THE FACE PLATE ON AN ELECTRIC OUTLET.

ARE YOU ABLE TO BEND OVER TO PICK UP COINS THAT ARE SCATTERED ON THE FLOOR?

ARE YOU ABLE TO STAND UP FROM A LOW SOFT COUCH WITHOUT HOLDING ON TO ANYTHING?

ARE YOU ABLE TO KNEEL ON THE FLOOR FOR A LONG TIME? FOR EXAMPLE WHEN CLEANING THE BATHTUB OR PLAYING WITH KIDS OR PET.
3-5 MINUTES

ARE YOU ABLE TO GO DOWN ONE FLIGHT OF STAIRS USING A HANDRAIL?
A FLIGHT OF STAIRS IS 12-15 STEPS.

ARE YOU ABLE TO CLEAN A FLOOR USING A MOP?

ARE YOU ABLE TO CLEAN OUT A CLOSET?

ARE YOU ABLE TO LIFT A HEAVY BOX FROM THE FLOOR TO TABLE HEIGHT?

ARE YOU ABLE TO LIFT A PACKAGE WEIGHING 10 LBS?

ARE YOU ABLE TO CARRY A FULL KITCHEN TRASH BAG OUTSIDE?

ARE YOU ABLE TO LIFT A FULL SMALL (CARRY-ON SIZE) SUITCASE FROM THE FLOOR TO A HIGH SHELF?
A FULL CARRY-ON SUITCASE WEIGHS 20 POUNDS/8 KG.

ARE YOU ABLE TO UNLOAD A FULL GROCERY CART INTO A CAR?

ARE YOU ABLE TO MOVE A SOFA TO CLEAN UNDER IT?

ARE YOU ABLE TO CARRY A FULL PAPER GROCERY BAG FOR 30 FEET?

ARE YOU ABLE TO CARRY A FULL LAUNDRY BASKET FOR 30 FEET?

ARE YOU ABLE TO WORK OVERHEAD FOR 20 MINUTES? FOR EXAMPLE ORGANIZING A HIGH SHELF IN A CLOSET.

ARE YOU ABLE TO LIFT A FULL LARGE (CHECK-IN SIZE) SUITCASE FROM THE FLOOR TO TABLE HEIGHT?
A FULL LARGE SUITCASE WEIGHS 40-50 POUNDS/18-23 KG

ARE YOU ABLE TO CARRY A FULL LAUNDRY BASKET UP A FLIGHT OF STAIRS?
A FLIGHT OF STAIRS IS 12-15 STEPS.

ARE YOU ABLE TO DO YARD WORK FOR 2 HOURS WITH OCCASIONAL REST? FOR EXAMPLE PLANT SHRUBS OR A GARDEN.”

ARE YOU ABLE TO DO HEAVY HOUSEWORK? FOR EXAMPLE SCRUBBING FLOORS WASHING WINDOWS MOVING FURNITURE TO CLEAN.

Upper Body Function (39 items)

Response options:

  Yes, without difficulty
  Yes, with a little difficulty
  Yes, with some difficulty
  Yes, with a lot of difficulty
  Unable to do
  I don't know

ARE YOU ABLE TO LEAN FORWARD TO BRUSH YOUR TEETH OVER A SINK?

ARE YOU ABLE TO LOOK OVER YOUR SHOULDER TO BACK UP IN A CAR?

ARE YOU ABLE PULL A SMALL SUITCASE BY THE HANDLE?

ARE YOU ABLE TO CARRY YOUR JACKET?

ARE YOU ABLE TO LIFT A FULL 2 LITER SODA BOTTLE FROM TABLE HEIGHT TO A HIGH SHELF? A SODA BOTTLE WEIGHS 3.5 LBS/1.5 KG.

ARE YOU ABLE TO PULL OPEN A HEAVY DOOR?

ARE YOU ABLE TO GRIP THE STEERING WHEEL DURING A LONG DRIVE? FOR EXAMPLE A COUPLE OF HOURS.

ARE YOU ABLE TO CHOP OR SLICE VEGETABLES FOR A LARGE MEAL?

ARE YOU ABLE TO HOLD AN UMBRELLA?

ARE YOU ABLE TO USE TWEEZERS?

ARE YOU ABLE TO USE A NUT CRACKER?

ARE YOU ABLE TO REMOVE A DOLLAR BILL FROM YOUR WALLET?

ARE YOU ABLE TO PUT COINS INTO A SLOT? FOR EXAMPLE A VENDING MACHINE.

ARE YOU ABLE TO PUSH THE CORRECT BUTTONS ON A REMOTE CONTROL?

ARE YOU ABLE TO USE A MOUSE TO SELECT WHAT YOU NEED ON A COMPUTER SCREEN?

ARE YOU ABLE TO CLOSE A ZIP LOCK BAG?

ARE YOU ABLE TO CLOSE A TWIST TIE ON A BAG OF BREAD?

ARE YOU ABLE TO PEEL THE STICKER OFF SOMETHING YOU BOUGHT?

ARE YOU ABLE TO OPEN A BOTTLE OF SODA?

ARE YOU ABLE TO INSERT A PLUG INTO AN ELECTRIC OUTLET?

ARE YOU ABLE TO USE A CHIP CLIP TO CLOSE A BAG?

ARE YOU ABLE TO TURN A DIAL? FOR EXAMPLE ON A STOVE.

ARE YOU ABLE TO USE THE TRIGGER ON A SPRAY BOTTLE?

ARE YOU ABLE TO BUTTON YOUR SHIRT?

ARE YOU ABLE TO PUT ON A WATCH OR BRACELET?

ARE YOU ABLE TO BUCKLE A STRAP? FOR EXAMPLE ON A BICYCLE HELMET CHILDS CAR SEAT OR BACKPACK.

ARE YOU ABLE TO WRITE FOR 20 MINUTES?

ARE YOU ABLE TO TIGHTEN SCREWS BY HAND WITH A SCREWDRIVER?

ARE YOU ABLE TO TURN A KEY IN A DOOR LOCK?

ARE YOU ABLE TO PUT BATTERIES IN A FLASHLIGHT OR REMOTE CONTROL FOR YOUR TELEVISION?

ARE YOU ABLE TO TURN FAUCETS ON AND OFF?

ARE YOU ABLE TO REMOVE WRAPPINGS FROM SMALL OBJECTS? FOR EXAMPLE LIKE REMOVING THE PACKAGING FROM A PACK OF BATTERIES.

ARE YOU ABLE TO REACH BEHIND YOU TO GET YOUR SEATBELT?
A SHOULDER HARNESS SEATBELT.

ARE YOU ABLE TO PICK UP COINS FROM A TABLE TOP?

ARE YOU ABLE TO OPEN CHILDPROOF MEDICINE BOTTLES OR JARS?

ARE YOU ABLE TO A CAN WITH A HAND CAN OPENER?

ARE YOU ABLE TO USE A HAMMER TO POUND A NAIL?

ARE YOU ABLE TO PICK OUT ONE KEY FROM GROUP OF KEYS?

ARE YOU ABLE TO OPEN PREVIOUSLY OPENED JARS?

Community Mobility ( formerly transportation) (17 items)

Response options:

  Yes, without difficulty
  Yes, with a little difficulty
  Yes, with some difficulty
  Yes, with a lot of difficulty
  Unable to do
  I don't know

Able to go where you need to be each day

Able to get a ride to where you need to go

Able to drive in the rain

Able to drive at night

Able to drive in heavy traffic

Able to park the car in a parking lot

Able to stay within the lane while driving

Able to merge onto a busy road

Able to drive in own neighborhood

Able to back out of a driveway

Able to use a bus/train schedule to get to familiar places

Able to use a bus/train schedule to get to unfamiliar places

Able to get on the right bus/train

Able to get on to a bus/train

Able to get off the bus/train before the doors close

Can drive to a local store and back home

Can get to the bus/train station on time

Social Appropriateness (7 items)

Response options:

  Strongly agree
  Agree
  Disagree
  Strongly disagree
  I don't know

Have trouble taking a shower/bath often enough

Have trouble getting cleaned up often enough

Have trouble keeping my hair groomed

Feel over/under dressed often

Need to dress better

Need to take a shower/bath more often

Need to do a better job getting cleaned up

Communication and Cognition ( 62 items)

Response options:

  Strongly agree
  Agree
  Disagree
  Strongly disagree
  I don't know

and

  Yes, without difficulty
  Yes, with a little difficulty
  Yes, with some difficulty
  Yes, with a lot of difficulty
  Unable to do
  I don't know

Able to discuss your ideas with others

Able to make small talk

Able to figure out why a joke is funny

Can keep up a conversation

Able to understand people in noisy places

Able to speak clearly

Able to get information needed when talking with people

Able to get your point across when speaking

Able to organize what you want to say

Able to give directions

Able to tell a doctor about a health problem

Able to tell others your needs

Able to understand body language and facial expressions

Able to understand people on the phone

Able to make an appointment over the phone

Able to write reminder notes

Able to fill out applications

Can follow what is being said when talking with someone

People can understand me when I talk

Make mistakes often when writing down numbers

Able to learn to do new things

Able to do two things at once

Able to check that your bills are correct

Able figure out the correct price for an on sale item

Able to pay attention when someone is talking for a short time

Able to work hard on tasks you don't like

Able to use bank cards and ATMs

Able to make everyday decisions

Able to think things through before making a decision

Able to remember important numbers

Able to remember things for a short time

Able to remember the names of people

Able to recall information

Able to remember something read or heard earlier in the day

Able to keep track of the day of the week

Able to find your way around in unfamiliar places

Able to find your way around in familiar places

Able to keep important papers organized

Able to get to places on time

Able to follow instructions given over the phone

Able to understand written instructions

Able to keep yourself safe at home

Notices own mistakes

Able to wait your turn to speak

Can relate to other people's feelings

Able to get point across when upset

Adjust to a new situation or change

Able to pay attention for a long period of time

Able to keep track of what needs to be done each day

Able to do regular chores

Able to remember a list of 4 or 5 errands without writing it

Able to manage your time each day

Able to finish things that you start

Able to think quickly

Able to ask for help from others when difficult problems come up

Have to read several times to understand

Able to multi-task

Able to do work carefully

Good at following through with plans

Able to take your medications correctly

Able to keep your medical appointments

Takes a long time to run errands

Resilience (formerly self-efficacy) (34 items)

Response options:

  Strongly agree
  Agree
  Disagree
  Strongly disagree
  I don't know

I can handle stressful situations

It's easy to do what people in authority ask me to do

I am the person most responsible for my own well being

I ask for help when I need to

I have a desire to succeed

I don't mind when people give me advice

I get along well with people outside my family

I feel that there are people I can turn to

When I'm asked to do a really difficult task, I keep at it until I get it done

If I make a mistake, I know I can deal with it

I think people trust me

I look at both sides of an issue

I am willing to accept help from others

I am comfortable making eye contact with others

Most people like what I have to say

I'm usually able to help solve other people's problems

I'm comfortable just seeing what the day brings

I look for the good in difficult situations

I learn from my mistakes

I respect other people's point of view

People tell me I'm flexible and agreeable

I always try to get along with others

I work well in a group

I respect other people

I am able to adjust to other people's ways

Able to work out a problem

I usually accomplish what I set out to do

I am good at making new friends

I'm comfortable trying different ways to do things

I like large family gatherings

I believe that things end up alright most of the time

I can get back on track when I am distracted

I make an effort to get to know other people

I am afraid of being with other people

Interpersonal Interactions (33 items)

Response options:

  Strongly agree
  Agree
  Disagree
  Strongly disagree
  I don't know

Stand too close to people when talking to them

Others have said that you do things that are dangerous

People say I show no emotion

I often get upset with the people around me

People often tell me my behavior is inappropriate

I can hear things that others can't

I have difficulty following the rules

I find that I have a hard time sitting still when I need to

I am always watching or on guard for threats

I often get angry when I'm told what to do

Sometimes I do things to hurt myself

Sometimes I feel on top of the world for no reason

I have difficulty calming down

I get very loud when I do not get what I want

I sometimes get physical when I'm angry

Sometimes I shout or yell for no reason

People know that I get angry easily

I can't stop myself from doing the same thing over and over

I feel people are against me

I often have difficulty dealing with people

People have told me that sometimes I act strange

I have a hard time accepting criticism

I often say things that upset others

I threatened violence toward people or property

I had trouble controlling my temper

When I am stressed, I find myself losing control

The same thoughts keep running through my head

I had sudden feelings of panic

Have trouble getting started on things to do

I worry about my health a lot

I have difficulty letting people know how I feel

I looked forward with enjoyment to upcoming events

I respect other people's property

I feel that I'm an important part of the community where I live

Mood and Emotions (34 items)

Response options:

  Strongly agree
  Agree
  Disagree
  Strongly disagree
  I don't know

In the past 7 days, I felt that nothing could cheer me up.

In the past 7 days, I felt something awful would happen.

In the past 7 days, I suddenly became emotional for no reason.

In the past 7 days, just being around people irritated me.

In the past 7 days, I felt that nothing was interesting.

In the past 7 days, I felt that I had nothing to look forward to.

In the past 7 days, I felt hopeless about the future.

In the past 7 days, I had sudden feelings of panic.

In the past 7 days, I felt indecisive. Hint: Indecisive meaning having trouble making decisions

In the past 7 days, I got fidgety. Hint: Fidgety meaning unable to sit still.

In the past 7 days, I have trouble keeping in touch with others.

In the past 7 days, I felt nervous when my normal routine was disturbed.

In the past 7 days, I avoided public places or activities.

In the past 7 days, I was afraid of what the future holds for me.

In the past 7 days, it was hard to adjust to unexpected changes.

In the past 7 days, I was bothered if I had to depend on others for help.

In the past 7 days, I was critical of myself for my mistakes.

Please specify your level of agreement: I feel good about myself.

In the past 7 days, I had trouble paying attention.

In the past 7 days, I was preoccupied with my worries.

Please specify your level of agreement: I am unable to think with all the noise in my head.

Please specify your level of agreement: I worry people are criticizing me even when they are not.

In the past 7 days, it was hard to keep up enthusiasm to get things done.

Please specify your level of agreement: I feel sick when I have to speak in front of people.

In the past 7 days, many situations made me worry.

In the past 7 days, I had trouble enjoying the things I used to enjoy.

Please specify your level of agreement: I don't know why I cry so often.

In the past 7 days, I felt emotionally exhausted.

Please specify your level of agreement: I stay alone at home to avoid people.

Please specify your level of agreement: I am so tired that I rest or sleep most of the day.

Please specify your level of agreement: I am so tired when I wake up, it's hard to get going.

Please specify your level of agreement: When I'm stressed, I can't figure out what to do.

Please specify your level of agreement: I dwell on my problems.

Please specify your level of agreement: I have a lot of energy.