| LP134470-6 | In the past 7 days I was able to stand up for myselfI was able to stand up for myself in the past 7 days | COMPONENT | 1 |
| LP134471-4 | I think I have fewer friends than other people my age in the past 7 days | COMPONENT | 1 |
| LP134472-2 | My friends ignored me in the past 7 days | COMPONENT | 1 |
| LP134473-0 | I wanted to spend time with my friends in the past 7 days | COMPONENT | 1 |
| LP134474-8 | I did things with other kids my age in the past 7 days | COMPONENT | 1 |
| LP134475-5 | I got along with my parents or guardians in the past 7 days | COMPONENT | 1 |
| LP134476-3 | I felt loved by my parents or guardians in the past 7 days | COMPONENT | 1 |
| LP134477-1 | I was happy at home in the past 7 days | COMPONENT | 1 |
| LP134478-9 | My parents or guardians spent enough time with me in the past 7 days | COMPONENT | 1 |
| LP134479-7 | I got along well with my teachers in the past 7 days | COMPONENT | 1 |
| LP134480-5 | My teachers accepted me in the past 7 days | COMPONENT | 1 |
| LP134481-3 | My teachers respected me in the past 7 days | COMPONENT | 1 |
| LP134482-1 | My parents or guardians seem to know what's important to me in the past 7 days | COMPONENT | 1 |
| LP134483-9 | I felt comfortable talking with my parents or guardians in the past 7 days | COMPONENT | 1 |
| LP134484-7 | I forget schoolwork that I need to do | COMPONENT | 1 |
| LP134485-4 | I sometimes forget what I was going to say | COMPONENT | 1 |
| LP134486-2 | I react slower than most people my age when I play games | COMPONENT | 1 |
| LP134487-0 | I forget things easily | COMPONENT | 1 |
| LP134488-8 | I have trouble remembering to do things like school projects | COMPONENT | 1 |
| LP134489-6 | It is hard for me to concentrate in school | COMPONENT | 1 |
| LP134490-4 | I have trouble paying attention to the teacher | COMPONENT | 1 |
| LP134491-2 | I have to work really hard to pay attention or I will make a mistake | COMPONENT | 1 |
| LP134492-0 | I have a hard time keeping track of my homework | COMPONENT | 1 |
| LP134493-8 | I forget to bring books or worksheets home that I need for homework | COMPONENT | 1 |
| LP134494-6 | I have to read something several times to understand it | COMPONENT | 1 |
| LP134495-3 | It is hard for me to find the right words to say what I mean | COMPONENT | 1 |
| LP134496-1 | It takes me longer than other people to get my schoolwork done | COMPONENT | 1 |
| LP134497-9 | I have to use written lists more often than other people my age so I will not forget things | COMPONENT | 1 |
| LP134498-7 | Being tired made it hard to play or go out with my friends as much as I would like in the past 7 days | COMPONENT | 1 |
| LP134499-5 | Being tired makes me sad in the past 7 days | COMPONENT | 1 |
| LP134500-0 | Being tired makes me mad in the past 7 days | COMPONENT | 1 |
| LP134501-8 | I had energy or strength in the past 7 days | COMPONENT | 1 |
| LP134502-6 | I could do my usual things at home in the past 7 days | COMPONENT | 2 |
| LP134503-4 | I got upset by being too tired to do things I wanted to do in the past 7 days | COMPONENT | 2 |
| LP134504-2 | I needed help doing my usual things at home in the past 7 days | COMPONENT | 2 |
| LP134505-9 | I felt weak in the past 7 days | COMPONENT | 1 |
| LP134506-7 | I had so much pain that I had to stop what I was doing in the past 7 days | COMPONENT | 1 |
| LP134507-5 | I had pain in the past 7 days | COMPONENT | 1 |
| LP134508-3 | When you had pain, how long did it last in the past 7 days | COMPONENT | 1 |
| LP134509-1 | I had trouble watching TV when I had pain in the past 7 days | COMPONENT | 1 |
| LP134510-9 | It was hard for me to play or hang out with my friends when I had pain in the past 7 days | COMPONENT | 1 |
| LP134511-7 | I could walk between rooms in the past 7 days | COMPONENT | 1 |
| LP134512-5 | I could get on and off the toilet without using my arms in the past 7 days | COMPONENT | 1 |
| LP134513-3 | I could get on and off a low chair in the past 7 days | COMPONENT | 1 |
| LP134514-1 | I could get up from the floor by myself in the past 7 days | COMPONENT | 1 |
| LP134515-8 | I could sit on a bench without support for 15 minutes in the past 7 days | COMPONENT | 1 |
| LP134516-6 | I could stand on my tiptoes to reach for something in the past 7 days | COMPONENT | 1 |
| LP134517-4 | I could stand on my tiptoes to put something, like a 5 lb bag of sugar, on a shelf in the past 7 days | COMPONENT | 1 |
| LP134518-2 | I fall down easily in the past 7 days | COMPONENT | 1 |
| LP134519-0 | I could walk on slightly uneven surfaces such as cracked pavement in the past 7 days | COMPONENT | 1 |