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

 General Details

Title:
Social Skills Improvement Systems (SSISS) Student Version
Short Name:
SSISStudent
Description:
"The SSIS (Social Skills Improvement System) Rating Scales enables targeted assessment of individuals and small groups to help evaluate social skills, problem behaviors, and academic competence. Teacher, parent and student forms help provide a comprehensive picture across school, home, and community settings.Gresham, F., & Elliott, S. N. (2007). Social Skills Improvement System (SSIS) Rating Scales. San Antonio, TX: Pearson Education Inc.;http://www.pearsonclinical.com/"
Disease:
Traumatic Brain Injury
Organization:
NIH/CIT/BRICS
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-12-06
Owner:
Number of Data Elements:
90
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

Social Skills (Appears Up To 46 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 Social Skills Improvement System (SSIS) Student-Question text 

(Draft)

Question text , as part of Social Skills Improvement System (SSIS) Student Version SSISSQuestionTxt Recommended UDE
3 Test item response text  The test (or assessment) item response text representing the answer for the items/questions of each test/assessment/questionnaire being asked. TestItemRespTxt Recommended CDE
4 Social Skills Improvement System (SSIS) Student-How true type 

(Draft)

How true type , as part of Social Skills Improvement System (SSIS) Student Version SSISSHowTrueTyp Recommended UDE

Problem Behaviors (Appears Up To 28 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 Social Skills Improvement System (SSIS) Student-Question text 

(Draft)

Question text , as part of Social Skills Improvement System (SSIS) Student Version SSISSQuestionTxt Recommended UDE
3 Test item response text  The test (or assessment) item response text representing the answer for the items/questions of each test/assessment/questionnaire being asked. TestItemRespTxt Recommended CDE
4 Social Skills Improvement System (SSIS) Student-How true type 

(Draft)

How true type , as part of Social Skills Improvement System (SSIS) Student Version SSISSHowTrueTyp Recommended UDE

SSISS Summary: Norm Group and F Index (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Social Skills Improvement System (SSIS)-Age interval type 

(Draft)

Age interval type , as part of Social Skills Improvement System (SSIS) SSISAgeIntvTyp Recommended UDE
2 Social Skills Improvement System(SSIS)-Sex norm group type 

(Draft)

Sex norm group type , as part of Social Skills Improvement System(SSIS) SSISSexNormGroupTyp Recommended UDE
3 Social Skills Adjustment System (SSIS)-Confidence interval type 

(Draft)

Confidence interval type , as part of Social Skills Adjustment System (SSIS) SSISConfInterTyp Recommended UDE
4 Social Skills Adjustment System (SSIS)-F index type 

(Draft)

F index type , as part of Social Skills Adjustment System (SSIS) SSISFIndexTyp Recommended UDE

SSISS Summary: Communication (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Social Skills Improvement System (SSIS) Student-Communication sum number 

(Draft)

Communication sum number , as part of Social Skills Improvement System (SSIS) Student Version SSISSCommunicationSumNum Recommended UDE
2 Social Skills Improvement System (SSIS) Student-Communication adjustment value 

(Draft)

Communication adjustment value , as part of Social Skills Improvement System (SSIS) Student Version SSISSCommunicationAdjVal Recommended UDE
3 Social Skills Improvement System (SSIS) Student-Communication raw score 

(Draft)

Communication raw score , as part of Social Skills Improvement System (SSIS) Student Version SSISSCommunicationRawScore Recommended UDE
4 Social Skills Adjustment System (SSIS)-Behavior level type 

(Draft)

Behavior level type , as part of Social Skills Adjustment System (SSIS) SSISBehaviorLevelTyp Recommended UDE

SSISS Summary: Cooperation (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Social Skills Improvement System (SSIS) Student-Cooperation sum number 

(Draft)

Cooperation sum number , as part of Social Skills Improvement System (SSIS) Student Version SSISSCooperationSumNum Recommended UDE
2 Social Skills Improvement System (SSIS) Student-Cooperation adjustment value 

(Draft)

Cooperation adjustment value , as part of Social Skills Improvement System (SSIS) Student Version SSISSCooperationAdjVal Recommended UDE
3 Social Skills Improvement System (SSIS) Student-Cooperation raw score 

(Draft)

Cooperation raw score , as part of Social Skills Improvement System (SSIS) Student Version SSISSCooperationRawScore Recommended UDE
4 Social Skills Adjustment System (SSIS)-Behavior level type 

(Draft)

Behavior level type , as part of Social Skills Adjustment System (SSIS) SSISBehaviorLevelTyp Recommended UDE

SSIS Summary:Assertion (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Social Skills Improvement System (SSIS) Student-Assertion sum number 

(Draft)

Assertion sum number , as part of Social Skills Improvement System (SSIS) Student Version SSISSAssertionSumNum Recommended UDE
2 Social Skills Improvement System (SSIS) Student-Assertion adjustment value 

(Draft)

Assertion adjustment value , as part of Social Skills Improvement System (SSIS) Student Version SSISSAssertionAdjVal Recommended UDE
3 Social Skills Improvement System (SSIS) Student-Assertion raw score 

(Draft)

Assertion raw score , as part of Social Skills Improvement System (SSIS) Student Version SSISSAssertionRawScore Recommended UDE
4 Social Skills Adjustment System (SSIS)-Behavior level type 

(Draft)

Behavior level type , as part of Social Skills Adjustment System (SSIS) SSISBehaviorLevelTyp Recommended UDE

SSISS Summary:Responsibility (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Social Skills Improvement System (SSIS) Student-Responsilibility sum number 

(Draft)

Responsilibility sum number , as part of Social Skills Improvement System (SSIS) Student Version SSISSResponsibilitySumNum Recommended UDE
2 Social Skills Improvement System (SSIS) Student-Responsibility adjustment vale 

(Draft)

Responsibility adjustment vale , as part of Social Skills Improvement System (SSIS) Student Version SSISSResponsibilityAdjVal Recommended UDE
3 Social Skills Improvement System (SSIS) Student-Responsilibility raw score 

(Draft)

Responsilibility raw score , as part of Social Skills Improvement System (SSIS) Student Version SSISSResponsibilityRawScore Recommended UDE
4 Social Skills Adjustment System (SSIS)-Behavior level type 

(Draft)

Behavior level type , as part of Social Skills Adjustment System (SSIS) SSISBehaviorLevelTyp Recommended UDE

SSISS Summary: Empathy (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Social Skills Improvement System (SSIS) Student-Empathy sum number 

(Draft)

Empathy sum number , as part of Social Skills Improvement System (SSIS) Student Version SSISSEmpathySumNum Recommended UDE
2 Social Skills Improvement System (SSIS) Student-Empathy adjustment value 

(Draft)

Empathy adjustment value , as part of Social Skills Improvement System (SSIS) Student Version SSISSEmpathyAdjVal Recommended UDE
3 Social Skills Improvement System (SSIS) Student-Empathy raw score 

(Draft)

Empathy raw score , as part of Social Skills Improvement System (SSIS) Student Version SSISSEmpathyRawScore Recommended UDE
4 Social Skills Adjustment System (SSIS)-Behavior level type 

(Draft)

Behavior level type , as part of Social Skills Adjustment System (SSIS) SSISBehaviorLevelTyp Recommended UDE

SSISS Summary:Engagement (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Social Skills Improvement System (SSIS) Student-Engagement sum number 

(Draft)

Engagement sum number , as part of Social Skills Improvement System (SSIS) Student Version SSISSEngagementSumNum Recommended UDE
2 Social Skills Improvement System (SSIS) Student-Engagment adjustment value 

(Draft)

Engagment adjustment value , as part of Social Skills Improvement System (SSIS) Student Version SSISSEngagementAdjVal Recommended UDE
3 Social Skills Improvement System (SSIS) Student-Engagement raw score 

(Draft)

Engagement raw score , as part of Social Skills Improvement System (SSIS) Student Version SSISSEngagementRawScore Recommended UDE
4 Social Skills Adjustment System (SSIS)-Behavior level type 

(Draft)

Behavior level type , as part of Social Skills Adjustment System (SSIS) SSISBehaviorLevelTyp Recommended UDE

SSISS Summary:Self-Control (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Social Skills Improvement System (SSIS) Student-Self control sum number 

(Draft)

Self control sum number , as part of Social Skills Improvement System (SSIS) Student Version SSISSSelfControlSumNum Recommended UDE
2 Social Skills Improvement System (SSIS) Student-Self-control adjustment value 

(Draft)

control adjustment value , as part of Social Skills Improvement System (SSIS) Student Version Parent-Self SSISSSelfControlAdjVal Recommended UDE
3 Social Skills Improvement System (SSIS) Student-Self control raw score 

(Draft)

Self control raw score , as part of Social Skills Improvement System (SSIS) Student Version SSISSSelfControlRawScore Recommended UDE
4 Social Skills Adjustment System (SSIS)-Behavior level type 

(Draft)

Behavior level type , as part of Social Skills Adjustment System (SSIS) SSISBehaviorLevelTyp Recommended UDE

SSISS Summary: Social Skills Scale (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Social Skills Improvement System (SSIS) Student-Social skills raw score 

(Draft)

Social skills raw score , as part of Social Skills Improvement System (SSIS) Student Version SSISSSocSkillsRawScore Recommended UDE
2 Social Skills Improvement System (SSIS) Student-Standard score 

(Draft)

Standard score , as part of Social Skills Improvement System (SSIS) Student Version SSISSStandScore Recommended UDE
3 Social Skills Adjustment System (SSIS)-Confidence interval type 

(Draft)

Confidence interval type , as part of Social Skills Adjustment System (SSIS) SSISConfInterTyp Recommended UDE
4 Social Skills Improvement System (SSIS) Student-Percentile rank value 

(Draft)

Percentile rank value , as part of Social Skills Improvement System (SSIS) Student Version SSISSPercentileRnkVal Recommended UDE

SSISS Summary: Externalizing (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Social Skills Improvement System (SSIS) Student-Externalizaing sum number 

(Draft)

Externalizaing sum number , as part of Social Skills Improvement System (SSIS) Student Version SSISSExternalizingSumNum Recommended UDE
2 Social Skills Improvement System (SSIS) Student-Externalizing adjustment value 

(Draft)

Externalizing adjustment value , as part of Social Skills Improvement System (SSIS) Student Version SSISSExternalizingAdjVal Recommended UDE
3 Social Skills Improvement System (SSIS) Student-Externalizaing raw score 

(Draft)

Externalizaing raw score , as part of Social Skills Improvement System (SSIS) Student Version SSISSExternalizingRawScore Recommended UDE
4 Social Skills Adjustment System (SSIS)-Behavior level type 

(Draft)

Behavior level type , as part of Social Skills Adjustment System (SSIS) SSISBehaviorLevelTyp Recommended UDE

SSISS Summary: Bullying (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Social Skills Improvement System (SSIS) Student-Bullying sum number 

(Draft)

Bullying sum number , as part of Social Skills Improvement System (SSIS) Student Version SSISSBullyingSumNum Recommended UDE
2 Social Skills Improvement System (SSIS) Student-Bullying adjustment value 

(Draft)

Bullying adjustment value , as part of Social Skills Improvement System (SSIS) Student Version SSISSBullyingAdjVal Recommended UDE
3 Social Skills Improvement System (SSIS) Student-Bullying raw score 

(Draft)

Bullying raw score , as part of Social Skills Improvement System (SSIS) Student Version SSISSBullyingRawScore Recommended UDE
4 Social Skills Adjustment System (SSIS)-Behavior level type 

(Draft)

Behavior level type , as part of Social Skills Adjustment System (SSIS) SSISBehaviorLevelTyp Recommended UDE

SSISS Summary: Hyperactivity/Inattention (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Social Skills Improvement System (SSIS) Student-Hyperactivity inattention sum number 

(Draft)

Hyperactivity inattention sum number , as part of Social Skills Improvement System (SSIS) Student Version SSISSHyperInattSumNum Recommended UDE
2 Social Skills Improvement System (SSIS) Student-Hyperactivity/inattention adjustment value 

(Draft)

Hyperactivity/inattention adjustment value , as part of Social Skills Improvement System (SSIS) Student Version SSISSHyperInattAdjVal Recommended UDE
3 Social Skills Improvement System (SSIS) Student-Hyperactivity inattention raw score 

(Draft)

Hyperactivity inattention raw score , as part of Social Skills Improvement System (SSIS) Student Version SSISSHyperInattRawScore Recommended UDE
4 Social Skills Adjustment System (SSIS)-Behavior level type 

(Draft)

Behavior level type , as part of Social Skills Adjustment System (SSIS) SSISBehaviorLevelTyp Recommended UDE

SSISS Summary: Internalizing (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Social Skills Improvement System (SSIS) Student-Internalizing sum number 

(Draft)

Internalizing sum number , as part of Social Skills Improvement System (SSIS) Student Version SSISSInternalizingSumNum Recommended UDE
2 Social Skills Improvement System (SSIS) Student-Internalizing adjustment value 

(Draft)

Internalizing adjustment value , as part of Social Skills Improvement System (SSIS) Student Version SSISSInternalizingAdjVal Recommended UDE
3 Social Skills Improvement System (SSIS) Student-Internalizing raw score 

(Draft)

Internalizing raw score , as part of Social Skills Improvement System (SSIS) Student Version SSISSInternalizingRawScore Recommended UDE
4 Social Skills Adjustment System (SSIS)-Behavior level type 

(Draft)

Behavior level type , as part of Social Skills Adjustment System (SSIS) SSISBehaviorLevelTyp Recommended UDE

SSISS Summary: Problem Behaviors Scale (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Social Skills Improvement System (SSIS) Student-Problem behaviors sum number 

(Draft)

Problem behaviors sum number , as part of Social Skills Improvement System (SSIS) Student Version SSISSProbBehaviorsSumNum Recommended UDE
2 Social Skills Improvement System (SSIS) Student-Problem behaviors adjustment value 

(Draft)

Problem behaviors adjustment value , as part of Social Skills Improvement System (SSIS) Student Version SSISSProbBehaviorsAdjVal Recommended UDE
3 Social Skills Improvement System (SSIS) Student-Problem behaviors raw score 

(Draft)

Problem behaviors raw score , as part of Social Skills Improvement System (SSIS) Student Version SSISSProbBehaviorsRawScore Recommended UDE
4 Social Skills Improvement System (SSIS) Student-Standard score 

(Draft)

Standard score , as part of Social Skills Improvement System (SSIS) Student Version SSISSStandScore Recommended UDE
5 Social Skills Adjustment System (SSIS)-Confidence interval type 

(Draft)

Confidence interval type , as part of Social Skills Adjustment System (SSIS) SSISConfInterTyp Recommended UDE
6 Social Skills Improvement System (SSIS) Student-Percentile rank value 

(Draft)

Percentile rank value , as part of Social Skills Improvement System (SSIS) Student Version SSISSPercentileRnkVal Recommended UDE

Analysis of Social Behaviors (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Social Skills Improvement System (SSIS) Student-Social skills strengths text 

(Draft)

Social skills strengths text , as part of Social Skills Improvement System (SSIS) Student Version SSISSSocSkillsStrengthsTxt Recommended UDE
2 Social Skills Improvement System (SSIS) Student-Social skills performance deficits text 

(Draft)

Social skills performance deficits text , as part of Social Skills Improvement System (SSIS) Student Version SSISSSockSkillsPerfDeficitTxt Recommended UDE
3 Social Skills Improvement System (SSIS) Student-Social skills acquisition deficits text  Social skills acquisition deficits text , as part of Social Skills Improvement System (SSIS) Student Version SSISSSocSkillsAcqDeficitTxt Recommended UDE
4 Social Skills Improvement System (SSIS) Student-Competing problem behaviors text 

(Draft)

Competing problem behaviors text , as part of Social Skills Improvement System (SSIS) Student Version SSISSCompetingProbBehaviorTxt Recommended UDE

Additional Assessment Information (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Social Skills Improvement System (SSIS) Student-Summary text 

(Draft)

Summary text , as part of Social Skills Improvement System (SSIS) Student Version SSISSSummaryTxt Recommended UDE
2 Social Skills Improvement System (SSIS) Student-Assessment date 

(Draft)

Assessment date , as part of Social Skills Improvement System (SSIS) Student Version SSISSAssessmentDate Recommended UDE
3 Social Skills Improvement System (SSIS) Student-Additional assessment information type 

(Draft)

Additional assessment information type , as part of Social Skills Improvement System (SSIS) Student Version SSISSAdditionalAssessInfoTyp Recommended UDE

Intervention Planning Notes (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Social Skills Improvement System (SSIS) Student-Intervention planning notes type 

(Draft)

Intervention planning notes type , as part of Social Skills Improvement System (SSIS) Student Version SSISSIntPlanningNotesTyp Recommended UDE
2 Social Skills Improvement System (SSIS) Student-Summary text 

(Draft)

Summary text , as part of Social Skills Improvement System (SSIS) Student Version SSISSSummaryTxt Recommended UDE

 Change History

 Administrative Change History