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

 General Details

Title:
Wechsler Intelligence Scale for Children -Fourth edition (WISC-IV) Picture Concepts section
Short Name:
WISCIVPC
Description:
WISC-IV measures a child's intellectual ability. In the Picture Concepts subtest, from each of two or three rows of objects, the child selects objects that go together based on an underlying concept. Wechsler, D. (2003). Wechsler Intelligence Scale for Children–Fourth Edition: Technical and interpretive manual. San Antonio, TX: Psychological Corporation. Copyright 2003 by The Psychological Corporation, a Harcourt Assessment Company 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:
2016-07-25
Owner:
Number of Data Elements:
40
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

WISC-IV Picture Concepts-Sample item A (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - Response range 1 to 4 number  Picture concept range number ranging from 1 to 4, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnRespnsRange1to4Num Recommended CDE

WISC-IV Picture Concepts-Sample item B (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - Response range 1 to 4 number  Picture concept range number ranging from 1 to 4, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnRespnsRange1to4Num Recommended CDE

WISC-IV Picture Concepts-Items 1 to 5 (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 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - Response range 1 to 4 number  Picture concept range number ranging from 1 to 4, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnRespnsRange1to4Num Recommended CDE
3 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - Item score  Item score, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnItemScore Recommended CDE

WISC-IV Picture Concepts-Items 6 to 12 (Appears Up To 7 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 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - Response 6 to 12 number  Picture concept range number ranging from 1 to 6, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnRespnsRange1to6Num Recommended CDE
3 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - Item score  Item score, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnItemScore Recommended CDE

WISC-IV Picture Concepts-Items 13 to 17 (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 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - Response 13 to 17 number  Picture concept range number ranging from 1 to 9, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnRespnsRange1to9Num Recommended CDE
3 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - Item score  Item score, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnItemScore Recommended CDE

WISC-IV Picture Concepts-Items 18 to 19 (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 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - Response 18 to 19 number  Picture concept range number ranging from 1 to 12, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnRespnsRange1to12Num Recommended CDE
3 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - Item score  Item score, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnItemScore Recommended CDE

WISC-IV Picture Concepts-Items 20 to 21 (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 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - Response 13 to 17 number  Picture concept range number ranging from 1 to 9, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnRespnsRange1to9Num Recommended CDE
3 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - Item score  Item score, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnItemScore Recommended CDE

WISC-IV Picture Concepts-Items 22 to 26 (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 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - Response 18 to 19 number  Picture concept range number ranging from 1 to 12, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnRespnsRange1to12Num Recommended CDE
3 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - Item score  Item score, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnItemScore Recommended CDE

WISC-IV Picture Concepts-Item 27 (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - Response 13 to 17 number  Picture concept range number ranging from 1 to 9, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnRespnsRange1to9Num Recommended CDE
2 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - Item score  Item score, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnItemScore Recommended CDE

WISC-IV Picture Concepts-Item 28 (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - Response 18 to 19 number  Picture concept range number ranging from 1 to 12, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnRespnsRange1to12Num Recommended CDE
2 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - Item score  Item score, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnItemScore Recommended CDE

WISC-IV Picture Concepts-Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Wechsler Intelligence Scale For Children - Fourth Edition (WISC - IV) Picture Concepts Section - PCn total raw score  Picture concepts (PCn) total score, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV), Picture Concept subtest WISCIVPCnTtlRawScore Recommended CDE

 Change History

 Administrative Change History