This form structure is an organized set of data definitions for a copyrighted form

 General Details

Title:
Tests for Auditory Processing Disorders for Children (SCAN-3:C)-Diagnostic Tests
Short Name:
SCAN3CDiagnosticTests
Description:
SCAN3-C is designed to identify auditory processing disorders in children. Diagnostic tests include Filtered Words (FW), Auditory Figure-Ground + 8 dB (AFG +8), Competing Words-Directed Ear (CW-DE) and Competing Sentences (CS). Keith, R. W. (2009). SCAN-3 for Children: Test for Auditory Processing Disorders. Pearson. Copyright 2009, 2000 NCS Pearson, Inc. http://www.pearsonclinical.com/
Disease:
Traumatic Brain Injury
Organization:
FITBIR
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-08-25
Owner:
Number of Data Elements:
78
eForms:
N

 Documentation


 Groups & Attached Data Elements

Logically grouped data elements with defined frequency at which they repeat.

# Title Short Description Variable Name Required? Type
1 GUID   Global Unique ID which uniquely identifies a subject GUID Required CDE
2 Subject identifier number   An identification number assigned to the participant/subject within a given protocol or a study. SubjectIDNum Optional CDE
3 Age in years   Value for participant's subject age recorded in years. AgeYrs Recommended CDE
4 Vital status   Status of participant/subject as alive or dead VitStatus Optional CDE
5 Visit date   Actual interview or visit date VisitDate Recommended CDE
6 Site name   The name of the site for the study SiteName Recommended CDE
7 Days since baseline   The number of days since baseline DaysSinceBaseline Optional CDE
8 Case control indicator   Indicator of whether subject is in the case or control arm of the study CaseContrlInd Optional CDE
9 General notes text   General notes GeneralNotesTxt Optional CDE

Additional Element Groups

Listed below are your additional element groups.

Form Administration (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Language form administration ISO code  Code (ISO 639-2) for the language that was used for CRF/instrument/scale/etc. administration LangCRFAdministratISOCode Recommended CDE
2 Language form administration ISO code other text  The free-text field related to 'Language used for CRF/instrument/scale/etc. administration ISO code' specifying other text. LangCRFAdministratISOCodeOTH Recommended CDE
3 Context type  The context to which the questions were answered ContextType Recommended CDE
4 Context type other text  The free-text related to ContextType specifying other text ContextTypeOTH Recommended CDE
5 Data source  Source of the data provided on the case report form DataSource Recommended CDE
6 Data source other text  The free-text field related to Data source specifying other text. Source of the data provided on the case report form DataSourceOTH Recommended CDE

Filtered Words (Appears Up To 40 Times)

# Title Short Description Variable Name Required? Type
1 Test item number (numeric)  The test (or assessment) item number representing the sequence for the items/questions of each test/assessmet/questionnaire being asked TestItemNum Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Filtered Words word text  Word text for Filtered Words, as part of SCAN-3 for children (SCAN-3C) SCAN3CFWWordTxt Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Filtered Words response text  Response text for Filtered Words, as part of SCAN-3 for children (SCAN-3C) SCAN3CFWRespnsTxt Recommended CDE
4 Tests for Auditory Processing Disorders (SCAN, SCAN-3C, SCAN3-A) - Correctness status  Status regarding whether the words are repeated correctly, as part of SCAN-3 for children (SCAN-3C), A Test for Auditory Processing Disorders in Adolescents and Adults (SCAN3-A) and Test for Auditory Processing Disorders in Children-revised (SCAN-C) SCANCorrectnessStat Recommended CDE

Filtered Words-Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 SCAN-3:C Tests for Auditory Processing Disorders for Children - Filtered Words right ear score  Score calculated as the count of correct responses to test items 1 to 20 of Filtered Words for the right ear, as part of the SCAN-3 for children (SCAN-3C) SCAN3CFWREScore Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Filtered Words left ear score  Score calculated as the count of correct responses to test items 21 to 40 of Filtered Words for the left ear, as part of the SCAN-3 for children (SCAN-3C) SCAN3CFWLEScore Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Filtered Words total raw score  FW total score, as part of the SCAN-3 for children (SCAN-3C) SCAN3CFWTtlRawScore Recommended CDE

Auditory Figure-Ground +8 dB (Appears Up To 40 Times)

# Title Short Description Variable Name Required? Type
1 Test item number (numeric)  The test (or assessment) item number representing the sequence for the items/questions of each test/assessmet/questionnaire being asked TestItemNum Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Auditory Figure - Ground +8 dB word text  Word text for Auditory Figure-Ground +8 dB, as part of SCAN-3 for children (SCAN-3C) SCAN3CAFG8WordTxt Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Auditory Figure - Ground + 8 dB response text  Response text for Auditory Figure-Ground +8 dB, as part of SCAN-3 for children (SCAN-3C) SCAN3CAFG8RRespnsTxt Recommended CDE
4 Tests for Auditory Processing Disorders (SCAN, SCAN-3C, SCAN3-A) - Correctness status  Status regarding whether the words are repeated correctly, as part of SCAN-3 for children (SCAN-3C), A Test for Auditory Processing Disorders in Adolescents and Adults (SCAN3-A) and Test for Auditory Processing Disorders in Children-revised (SCAN-C) SCANCorrectnessStat Recommended CDE

Auditory Figure-Ground +8 dB-Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 SCAN-3:C Tests for Auditory Processing Disorders for Children - Auditory Figure - Ground + 8 dB right ear score  Score calculated as the count of correct responses to test items 1 to 20 of Auditory Figure-Ground +8 dB for the right ear, as part of the SCAN-3 for children (SCAN-3C) SCAN3CAFG8REScore Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Auditory Figure - Ground + 8 dB left ear score  Score calculated as the count of correct responses to test items 21 to 40 of Auditory Figure-Ground +8 dB for the left ear, as part of the SCAN-3 for children (SCAN-3C) SCAN3CAFG8LEScore Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Auditory Figure - Ground + 8 dB total raw score  AFG+8 total score, as part of the SCAN-3 for children (SCAN-3C) SCAN3CAFG8TtlRawScore Recommended CDE

Competing Words-Directed Ear-right ear (Appears Up To 30 Times)

# Title Short Description Variable Name Required? Type
1 Test item number (numeric)  The test (or assessment) item number representing the sequence for the items/questions of each test/assessmet/questionnaire being asked TestItemNum Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Right Ear word text  Word text for Competing Words-Directed Right Ear, as part of SCAN-3 for children (SCAN-3C) SCAN3CCWDREWordTxt Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Right Ear response text  Response text for Competing Words-Directed Right Ear, as part of SCAN-3 for children (SCAN-3C) SCAN3CCWDRERespnsTxt Recommended CDE
4 Tests for Auditory Processing Disorders (SCAN, SCAN-3C, SCAN3-A) - Correctness status  Status regarding whether the words are repeated correctly, as part of SCAN-3 for children (SCAN-3C), A Test for Auditory Processing Disorders in Adolescents and Adults (SCAN3-A) and Test for Auditory Processing Disorders in Children-revised (SCAN-C) SCANCorrectnessStat Recommended CDE

Competing Words-Directed Ear-right ear-Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Right Ear right ear score  Score calculated as the count of correct responses to test items 1 to 15 of Competing Words-Directed Right Ear for the right ear, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCWDREREScore Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Right Ear left ear score  Score calculated as the count of correct responses to test items 16 to 30 of Competing Words-Directed Right Ear for the left ear, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCWDRELEScore Recommended CDE

Competing Words-Directed Ear-left ear (Appears Up To 30 Times)

# Title Short Description Variable Name Required? Type
1 Test item number (numeric)  The test (or assessment) item number representing the sequence for the items/questions of each test/assessmet/questionnaire being asked TestItemNum Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Left Ear word text  Word text for Competing Words-Directed Left Ear, as part of SCAN-3 for children (SCAN-3C) SCAN3CCWDLEWordTxt Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Left Ear response text  Response text for Competing Words-Directed Left Ear, as part of SCAN-3 for children (SCAN-3C) SCAN3CCWDLERespnsTxt Recommended CDE
4 Tests for Auditory Processing Disorders (SCAN, SCAN-3C, SCAN3-A) - Correctness status  Status regarding whether the words are repeated correctly, as part of SCAN-3 for children (SCAN-3C), A Test for Auditory Processing Disorders in Adolescents and Adults (SCAN3-A) and Test for Auditory Processing Disorders in Children-revised (SCAN-C) SCANCorrectnessStat Recommended CDE

Competing Words-Directed Ear-left ear-Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Left Ear right ear score  Score calculated as the count of correct responses to test items 1 to 15 of Competing Words-Directed Left Ear for the left ear, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCWDLELEScore Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Right Ear right ear score  Score calculated as the count of correct responses to test items 16 to 30 of Competing Words-Directed Left Ear for the right ear, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCWDLEREScore Recommended CDE

Competing Words-Directed Ear-Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Ear right ear total raw score  RE total score for Competing Words-Directed Ear, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCWDERETtlRawScore Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Ear left ear total raw score  LE total score for Competing Words-Directed Ear, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCWDELETtlRawScore Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Ear total raw score  CW-DE total score for Competing Words-Directed Ear, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCWDETtlRawScore Recommended CDE

Competing Sentences-Item 1 (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences word text  Competing Sentences word text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSWordTxt Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences response text  Competing Sentences response text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSRespnsTxt Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences words correct 4 count  Count of correct words of Competing Sentences with the maximum of 4, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSWordsCorrect4Ct Recommended CDE

Competing Sentences-Items 2-6 (Appears Up To 5 Times)

# Title Short Description Variable Name Required? Type
1 Test item number (numeric)  The test (or assessment) item number representing the sequence for the items/questions of each test/assessmet/questionnaire being asked TestItemNum Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences word text  Competing Sentences word text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSWordTxt Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences response text  Competing Sentences response text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSRespnsTxt Recommended CDE
4 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences words correct 3 count  Count of correct words of Competing Sentences with the maximum of 3, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSWordsCorrect3Ct Recommended CDE

Competing Sentences-Item 7 (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences word text  Competing Sentences word text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSWordTxt Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences response text  Competing Sentences response text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSRespnsTxt Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences words correct 5 count  Count of correct words of Competing Sentences with the maximum of 5, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSWordsCorrect5Ct Recommended CDE

Competing Sentences-Item 8 (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences word text  Competing Sentences word text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSWordTxt Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences response text  Competing Sentences response text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSRespnsTxt Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences words correct 3 count  Count of correct words of Competing Sentences with the maximum of 3, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSWordsCorrect3Ct Recommended CDE

Competing Sentences-Items 9-11 (Appears Up To 3 Times)

# Title Short Description Variable Name Required? Type
1 Test item number (numeric)  The test (or assessment) item number representing the sequence for the items/questions of each test/assessmet/questionnaire being asked TestItemNum Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences word text  Competing Sentences word text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSWordTxt Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences response text  Competing Sentences response text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSRespnsTxt Recommended CDE
4 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences words correct 4 count  Count of correct words of Competing Sentences with the maximum of 4, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSWordsCorrect4Ct Recommended CDE

Competing Sentences-Items 12-16 (Appears Up To 5 Times)

# Title Short Description Variable Name Required? Type
1 Test item number (numeric)  The test (or assessment) item number representing the sequence for the items/questions of each test/assessmet/questionnaire being asked TestItemNum Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences word text  Competing Sentences word text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSWordTxt Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences response text  Competing Sentences response text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSRespnsTxt Recommended CDE
4 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences words correct 3 count  Count of correct words of Competing Sentences with the maximum of 3, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSWordsCorrect3Ct Recommended CDE

Competing Sentences-Item 17 (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences word text  Competing Sentences word text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSWordTxt Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences response text  Competing Sentences response text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSRespnsTxt Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences words correct 5 count  Count of correct words of Competing Sentences with the maximum of 5, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSWordsCorrect5Ct Recommended CDE

Competing Sentences-Item 18 (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences word text  Competing Sentences word text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSWordTxt Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences response text  Competing Sentences response text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSRespnsTxt Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences words correct 3 count  Count of correct words of Competing Sentences with the maximum of 3, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSWordsCorrect3Ct Recommended CDE

Competing Sentences-Items 19-20 (Appears Up To 2 Times)

# Title Short Description Variable Name Required? Type
1 Test item number (numeric)  The test (or assessment) item number representing the sequence for the items/questions of each test/assessmet/questionnaire being asked TestItemNum Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences word text  Competing Sentences word text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSWordTxt Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences response text  Competing Sentences response text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSRespnsTxt Recommended CDE
4 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences words correct 4 count  Count of correct words of Competing Sentences with the maximum of 4, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSWordsCorrect4Ct Recommended CDE

Competing Sentences-Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences right ear total raw score  Raw score calculated as the Raw score calculated as the sum of words correct for items 1 to 10 of Completing Sentences, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSRETtlRawScore Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences left ear total raw score  Raw score calculated as the sum of words correct for items 11 to 20 of Completing Sentences, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSLETtlRawScore Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences total raw score  CS total score, as part of the SCAN-3 for children (SCAN-3C) SCAN3CCSTtlRawScore Recommended CDE

 Change History

 Administrative Change History