Yeast Questionnaire - Children

Circle the appropriate point score for questions you answer "yes." Total your score

and record it in the box at the end of the questionnaire.

1.    During the two years before your child was born, were you bothered by recurrent vaginitis, menstrual irregularities, pre- menstrual tension, fatigue, headache, depression, digestive disorders, or "feeling bad all over"?

.............................................................................................. 30

2.    Was your child bothered by thrush?  (Score 10 if mild, 20 if severe or persistent.)

....................................................................................... 10   20

3.    Was your child bothered by frequent diaper rashes in infancy? (Score 10 if mild, 20 if severe or persistent.)

....................................................................................... 10   20

4.    During infancy, was your child bothered by colic and irritabil-

ity lasting over 3 months?  (Score 10 if mild, 20 if moderate or severe.)

....................................................................................... 10   20

5.    Are  your child's symptoms worse on damp days or in damp or

moldy places?

.............................................................................................. 20

6.    Has your child been bothered by recurrent or persistent "ath- lete's foot" or chronic fungous infections of his skin or nails?

.............................................................................................. 30

7.    Has your child been bothered by recurrent hives, eczema, or

other skin problems?

.............................................................................................. 10

8.    Has your child received:

(A) 4 or more courses of antibiotic drugs during the past year? Or has he received continuous "prophy-lactic" courses of anti- biotic drugs?

............................................................................................ 60 (B) 8 or more courses of "broad-spectrum" antibiotics (i.e. Amoxicillin, Keflex, Septra, Bactrim, or Ceclor) during the past

3 years?

.............................................................................................. 30

9.    Has your child experienced recurrent ear problems?

.............................................................................................. 10

10.    Has your child had tubes inserted in his ears?

.............................................................................................. 10

11.    Has your child been labeled "hyperactive"?  (Score 10 if mild,

20 if moderate or severe.)

....................................................................................... 10   20

12.    Is your child bothered by learning problems (even though his early developmental history was normal?

.............................................................................................. 10

13.    Does your child have a short attention span?

.............................................................................................. 10

14.    Is your child persistently irritable, unhappy, and hard to please?

.............................................................................................. 10

15.    Has your child been bothered by persistent or recurrent diges- tive problems, including constipation, diarrhea, bloating, exces- sive gas?  (Score 10 if mild, 20 if moderate, 30 if severe.)

................................................................................ 10   20   30

16.    Has your child been bothered by persistent nasal congestion, cough, and/or wheezing?

.............................................................................................. 10

17.    Is your child unusually tired or unhappy or depressed?  (Score

10 if mild, 20 if severe.)

....................................................................................... 10   20

18.    Has your child been bothered by recurrent headaches, abdom- inal pain, or muscle aches?  (Score 10 if mild, 20 if severe.)

....................................................................................... 10   20

19.    Does your child crave sweets?

.............................................................................................. 10

20.    Do you feel that your child isn't well, yet diagnostic tests and studies haven't revealed the cause?

.............................................................................................. 10

GRAND TOTAL SCORE

Yeasts POSSIBLY play a role in causing health problems in children

with scores of 60 or more.

Yeasts PROBABLY play a role in causing health problems in children

with scores of 100 or more.

Yeasts ALMOST CERTAINLY play a role in causing health problems

in children with scores of 140 or more.

Copyright 1984, William G. Crook, M.D.