Table II.

Exemplar Adaptations and Extensions of PROMIS Parent-Proxy (5–17years) Items for PROMIS Early Childhood Parent Report (1–5years) Measures

Domain	Original PROMIS parent-proxy item	Adaptations	Developmentally specific featuresa
Global health	In general, how would you rate your child’s mental health, including mood and ability to think?	In general, how would you rate your child’s mental health?	How well is your child meeting developmental milestones?
		How would you rate your child’s mood?
		How would you rate your child’s ability to think?
Anger/irritability	My child was so angry he/she felt like throwing something.	My child broke or destroyed things during a temper tantrum.	My child had a temper tantrum till exhausted.
Anxiety	It was hard for my child to relax.	My child seemed tense.	My child was inconsolable when separating from me or other parent in a familiar setting.
Depressive symptoms	My child didn’t care about anything.	My child wasn’t interested in doing things he/she usually likes.	My child acted withdrawn when in a group of children.
Positive affect	My child felt enthusiastic.	My child was enthusiastic.	My child was playful.
Engagementb—curiosity	My child’s life is filled with things that interest him/her.	My child actively explored the world around him/her.	My child asked “why,” “what,” and “how” questions.
Engagementb—persistence	N/A	N/A	My child didn't give up when something was hard.
Self controlc—adaptability	N/A	N/A	My child adjusted easily to changes in routines.
Self controlc—self regulation	N/A	N/A	My child bounced back quickly when things didn’t go his/her way.
Social relationships	My child knew our family was interested in what he/she was doing.	Our family was interested in what my child was doing.	My child was good at expressing his/her needs to me or other parent.
	Other kids wanted to talk to my child.	Other kids wanted to play with my child.	My child showed interest in other children.
Physical activity	How many days did your child exercise or play so hard that his/her body got tired?	How many days did your child play so hard that he/she got physically exhausted?	How many days did your child play so hard that he/she fell asleep early?
			How many days did your child play so hard that he/she needed an extra or longer nap?
Sleep healthd	My child had trouble controlling his/her feelings because he/she was sleepy.	When my child didn’t get enough sleep, he/she became frustrated easily.	When my child didn’t sleep well, he/she had more temper tantrums than usual.

Note. N/A = No parallel PROMIS Parent-Proxy items exist. Therefore, all items within these item pools represent “developmentally specific features” of these domains.

^aAll items in the “developmentally specific features” columns are new items and not modifications of existing PROMIS items.

^bThe Engagement domain is the PROMIS EC adaptation for the PROMIS well-being domains of life satisfaction and meaning and purpose. While the overall domains were deemed inappropriate for 1- to 5-year-olds, several items from these banks were modified as part of the PROMIS EC Engagement measure.

^cThere is no comparable PROMIS domain for self-regulation but experts identified this construct as a critical component of early childhood well-being.

^dNo modifications were made to the PROMIS sleep disturbance items for use in early childhood, so only example items from the sleep-related impairment facet are presented.