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

 General Details

Title:
Wechsler Preschool and Primary Scale of Intelligence Third Edition- Block Design subtest
Short Name:
WPPSI3BD
Description:
WPPSI-III is a measure of intelligence in young children that is more age-appropriate and user-friendly. Block Design measures visual-motor coordination. Wechsler, D. (2002). Wechsler Preschool and Primary Scale of IntelligenceĀ—third edition technical and interpretive manual. San Antonio, TX: Psychological Corporation. Copyright 2002 by 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:
2016-07-29
Owner:
Number of Data Elements:
32
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

WPPSI-III-Block Design 1-6 (Appears Up To 6 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 Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) Block Design Section - Correct block design indicator  Correct design number indicator, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) WPPSI3BlockDesgnCorrInd Recommended CDE
3 Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) Block Design Section - Design 1-6 score  Score for Design 1-6, as part of Wechsler Preschool and Primary Scale of Intelligence - Third Edition (WPPSI - III) WPPSI3BlockDesgn1to6Score Recommended CDE
4 Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) Block Design Section - Completion time  Time to complete, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) WPPSI3BlockDesgnCompltTime Recommended CDE

WPPSI-III-Block Designs 7 (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) Block Design Section - Correct block design indicator  Correct design number indicator, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) WPPSI3BlockDesgnCorrInd Recommended CDE
2 Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) Block Design Section - Design 7 score  Score for Design 7, as part of Wechsler Preschool and Primary Scale of Intelligence - Third Edition (WPPSI - III) WPPSI3BlockDesgn7Score Recommended CDE
3 Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) Block Design Section - Completion time  Time to complete, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) WPPSI3BlockDesgnCompltTime Recommended CDE
4 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

WPPSI-III-Block Designs 8-13 (Appears Up To 6 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 Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) Block Design Section - Correct block design indicator  Correct design number indicator, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) WPPSI3BlockDesgnCorrInd Recommended CDE
3 Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) Block Design Section - Design 8-12 score  Score for Design 8-13, as part of Wechsler Preschool and Primary Scale of Intelligence - Third Edition (WPPSI - III) WPPSI3BlockDesgn8to13Score Recommended CDE
4 Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) Block Design Section - Completion time  Time to complete, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) WPPSI3BlockDesgnCompltTime Recommended CDE

WPPSI-III-Block Designs 14-20 (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 Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) Block Design Section - Correct block design indicator  Correct design number indicator, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) WPPSI3BlockDesgnCorrInd Recommended CDE
3 Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) Block Design Section - Design 14-20 score  Score for Design 14-20, as part of Wechsler Preschool and Primary Scale of Intelligence - Third Edition (WPPSI - III) WPPSI3BlockDesgn14to20Score Recommended CDE
4 Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) Block Design Section - Completion time  Time to complete, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) WPPSI3BlockDesgnCompltTime Recommended CDE

WPPSI-III-Block Design- scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI - III) Block Design Section - Total raw score  Total raw score, as part of Wechsler Preschool and Primary Scale of Intelligence - Third Edition (WPPSI - III) WPPSI3BlockDesgnTotalRawScore Recommended CDE

 Change History

 Administrative Change History