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

 General Details

Title:
Wechsler Preschool and Primary Scale of Intelligence Fourth Edition- Block Design subtest
Short Name:
WPPSI4BD
Description:
The WPPSI–IV is an innovative measure of cognitive development for preschoolers and young children that's rooted in contemporary theory and research that also places a strong emphasis on child-friendly, developmentally appropriate features and includes new processing speed tasks, the addition of working memory subtests, an expanded factor structure. The extensive enhancements are targeted to benefit both children and examiners. Block Design measures visual-motor coordination. Wechsler, D. (2012). Wechsler Preschool and Primary Scale of Intelligence—fourth edition technical manual and interpretive manual. San Antonio,TX: Psychological Corporation. Copyright 2012. Pearson, Inc., and/or its affiliates. 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:
2016-08-08
Owner:
Number of Data Elements:
33
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-IV-Block Design 1-4 (Appears Up To 8 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 Trial number (numeric)  The number representing the sequence for any repeated measure test or assessment when it is performed multiple times. TrialNumber Recommended CDE
3 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Completion time value  Time to complete, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) WPPSI4BDCompltTimeVal Recommended CDE
4 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Design 1-4 score  Score for Design 1-4, as part of Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition (WPPSI - IV) WPPSI4BD1to4Score Recommended CDE

WPPSI-IV-Block Designs 5 (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Completion time value  Time to complete, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) WPPSI4BDCompltTimeVal Recommended CDE
2 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Design 5 score  Score for Design 5, as part of Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition (WPPSI - IV) WPPSI4BD5Score Recommended CDE

WPPSI-IV-Block Designs 6-8 (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 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Completion time value  Time to complete, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) WPPSI4BDCompltTimeVal Recommended CDE
3 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Design 6-8 and 10 score  Score for Design 6-8 and 10, as part of Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition (WPPSI - IV) WPPSI4BD6to8And10Score Recommended CDE

WPPSI-IV-Block Designs 9 (Appears Up To 2 Times)

# Title Short Description Variable Name Required? Type
1 Trial number (numeric)  The number representing the sequence for any repeated measure test or assessment when it is performed multiple times. TrialNumber Recommended CDE
2 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Completion time value  Time to complete, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) WPPSI4BDCompltTimeVal Recommended CDE
3 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Design 9 score  Score for Design 9, as part of Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition (WPPSI - IV) WPPSI4BD9Score Recommended CDE

WPPSI-IV-Block Designs 10 (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Completion time value  Time to complete, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) WPPSI4BDCompltTimeVal Recommended CDE
2 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Design 6-8 and 10 score  Score for Design 6-8 and 10, as part of Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition (WPPSI - IV) WPPSI4BD6to8And10Score Recommended CDE

WPPSI-IV-Block Designs 11-17 (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 Fourth Edition (WPPSI - IV) Block Design Section - Completion time value  Time to complete, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) WPPSI4BDCompltTimeVal Recommended CDE
3 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Design 11-17 score  Score for Design 11-17, as part of Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition (WPPSI - IV) WPPSI4BD11to17Score Recommended CDE

WPPSI-IV-Block Design- Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Total raw score  Total raw score, as part of Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition (WPPSI - IV) WPPSI4BDTotalRawScore Recommended CDE

 Change History

 Administrative Change History