Questionnaire Text

Questionnaire form view entire document: text image

12. Does [the respondent] have a permanent limitation?? (You can mark multiple options)

[] 1 Seeing, even with glasses or contacts on
[] 2 Hearing
[] 3 Speaking
[] 4 Walking or going up steps
[] 5 Using arms or hands
[] 6 Intellectually (retarded, Down?s syndrome, other)
[] 7 Mentally (bipolar, schizophrenic, other)
[] 8 None of the above

Questionnaire instructions view entire document: text image

Question 12: Population with disability

12. Does [name] have a permanent limitation...? (You can mark multiple options)

[] 1 seeing, even with glasses or contacts on
[] 2 hearing
[] 3 speaking
[] 4 walking or going up steps
[] 5 using arms or hands
[] 6 intellectually (retarded, Down's syndrome, other)
[] 7 mentally (bipolar, schizophrenic, other)
[] 8 none of the above

This question is asked of all the habitual residents of the household. In the case of the babies, it should be considered that they do not have permanent limitations if there is no medical opinion that indicates otherwise.

As can be observed in this question you can mark various responses that refer to the following permanent limitations.

Speaking: this includes the people that present permanent difficulties speaking (expressing a thought orally). This excludes: the temporary problems speaking derived from some condition of shyness or stutter.