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)-Supplementary Tests
Short Name:
SCAN3CSupplementaryTests
Description:
SCAN3-C is designed to identify auditory processing disorders in children. Supplementary tests include Auditory Figure-Ground +12 dB (AFG +12), Auditory Figure-Ground 0 dB (AFG 0) and Time Compressed Sentences (TCS). 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:
36
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

Auditory Figure-Ground +12 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 + 12 dB word text  Word text for Auditory Figure-Ground +12 dB, as part of SCAN-3 for children (SCAN-3C) SCAN3CAFG12WordTxt Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Auditory Figure - Ground + 12 dB response text  Response text for Auditory Figure-Ground +12 dB, as part of SCAN-3 for children (SCAN-3C) SCAN3CAFG12RRespnsTxt 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 +12 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 + 12 dB right ear score  Score calculated as the count of correct responses to test items 1 to 20 of Auditory Figure-Ground +12 dB for the right ear, as part of the SCAN-3 for children (SCAN-3C) SCAN3CAFG12REScore Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Auditory Figure - Ground + 12 dB left ear score  Score calculated as the count of correct responses to test items 21 to 40 of Auditory Figure-Ground +12 dB for the left ear, as part of the SCAN-3 for children (SCAN-3C) SCAN3CAFG12LEScore Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Auditory Figure - Ground + 12 dB total raw score  AFG+12 total score, as part of the SCAN-3 for children (SCAN-3C) SCAN3CAFG12TtlRawScore Recommended CDE

Auditory Figure-Ground 0 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 0 dB word text  Word text for Auditory Figure-Ground 0 dB, as part of SCAN-3 for children (SCAN-3C) SCAN3CAFG0WordTxt Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Auditory Figure - Ground 0 dB response text  Response text for Auditory Figure-Ground 0 dB, as part of SCAN-3 for children (SCAN-3C) SCAN3CAFG0RRespnsTxt 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 0 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 0 dB right ear score  Score calculated as the count of correct responses to test items 1 to 20 of Auditory Figure-Ground 0 dB for the right ear, as part of the SCAN-3 for children (SCAN-3C) SCAN3CAFG0REScore Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Auditory Figure - Ground 0 dB left ear score  Score calculated as the count of correct responses to test items 21 to 40 of Auditory Figure-Ground 0 dB for the left ear, as part of the SCAN-3 for children (SCAN-3C) SCAN3CAFG0LEScore Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Auditory Figure - Ground 0 dB total raw score  AFG0 total score, as part of the SCAN-3 for children (SCAN-3C) SCAN3CAFG0TtlRawScore Recommended CDE

Time Compressed Sentences (Appears Up To 20 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 - Time Compressed Sentences word text  Time Compressed Sentences word text, as part of the SCAN-3 for children (SCAN-3C) SCAN3CTCSWordTxt Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Time Compressed Sentences response text  Time Compressed Sentences response, as part of the SCAN-3 for children (SCAN-3C) SCAN3CTCSRespnsTxt Recommended CDE
4 SCAN-3:C Tests for Auditory Processing Disorders for Children - Time Compressed Sentences words correct count  Count of correct words of Time Compressed Sentences, as part of the SCAN-3 for children (SCAN-3C) SCAN3CTCSWordsCorrectCt Recommended CDE

Time Compressed 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 - Time Compressed Sentences right ear total raw score  Raw score calculated as the sum of words correct for items 1 to 10 of Time Compressed Sentences, as part of the SCAN-3 for children (SCAN-3C) SCAN3CTCSRETtlRawScore Recommended CDE
2 SCAN-3:C Tests for Auditory Processing Disorders for Children - Time Compressed Sentences left ear total raw score  Raw score calculated as the sum of words correct for items 11 to 20 of Time Compressed Sentences, as part of the SCAN-3 for children (SCAN-3C) SCAN3CTCSLETtlRawScore Recommended CDE
3 SCAN-3:C Tests for Auditory Processing Disorders for Children - Time Compressed Sentences total raw score  TCS total score, as part of the SCAN-3 for children (SCAN-3C) SCAN3CTCSTtlRawScore Recommended CDE

 Change History

 Administrative Change History