Form Structure: Child and Adolescent Scale for Environment (CASE)
This form structure is an organized set of data definitions for a copyrighted form
Title:
Child and Adolescent Scale for Environment (CASE)
Short Name:
CASE
Description:
The Child and Adolescent Scale for Environment (CASE) consists of 18 items that measure environmental problems that might hinder a childs participation at home, school, and in the community. These problems may be physical, social, or attitudinal problems in the community, including lack of resources, crime, and negative perceptions of others. The scale is an adaptation of the Craig Hospital Inventory of Environment Factors (CHIEF). The CASE is completed by the parent and can be administered in about 5 minutes. Copyright 2011 Bedell G. The Child and Adolescent Scale of Environment (CASE): Administration and scoring guidelines. Available online at: http://sites.tufts.edu/garybedell/measurement-tools/ (Last accessed 6 May 2013) Bedell, G. (2004). Developing a follow-up survey focused on participation of children and youth with acquired brain injuries after inpatient rehabilitation. NeuroRehabilitation, 19, 191-205.
Disease:
General (For all diseases)
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:
2016-10-11
Owner:
Number of Data Elements:
42
eForms:
N
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 |
Child and Adolescent Scale for Environment (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Child and Adolescent Scale of Environment (CASE) - School work question type | The type of setting relating to the school or work question being asked, as part of the as part of the Child Adolescent Scale of Environment (CASE) | CASESchoolWorkQuesTyp | Recommended | CDE |
| 2 | Child and Adolescent Scale of Environment (CASE) - Home design layout problem scale | The scale relating to the child having a problem with the design or layout of his/her home, as part of the Child Adolescent Scale of Environment (CASE) | CASEHomeDesLayProbScl | Recommended | CDE |
| 3 | Child and Adolescent Scale of Environment (CASE) -Community building place design layout problem scale | The scale relating to the child having a problem with the design or layout of buildings or places that he or she uses in his/her community of neighborhood, as part of the Child Adolescent Scale of Environment (CASE) | CASEBuildPlaceDesLayProbScl | Recommended | CDE |
| 4 | Child and Adolescent Scale of Environment (CASE) - School work design layout problem scale | The scale relating to the child having a problem with the design or layout of his/her school or workplace, depending on which is selected, as part of the Child Adolescent Scale of Environment (CASE) | CASESchoolWorkDesLayProbScl | Recommended | CDE |
| 5 | Child and Adolescent Scale of Environment (CASE) - Child community support encouragement lack scale | The scale relating to the child lacking support or encouragement in his/her community or neighborhood, as part of the Child Adolescent Scale of Environment (CASE) | CASEChldComtySuprtEncLackScl | Recommended | CDE |
| 6 | Child and Adolescent Scale of Environment (CASE) - Child school work support encouragement lack scale | The scale relating to the child lacking support or encouragement at school or work, depending on which is selected, as part of the Child Adolescent Scale of Environment (CASE) | CASEChldSchWorkSuprtEncLackScl | Recommended | CDE |
| 7 | Child and Adolescent Scale of Environment (CASE) - School work attitude towards child problem scale | The scale relating to there being a problem with other people's attitudes towards the child at school or work, depending on which is selceted, as part of the Child Adolescent Scale of Environment (CASE) | CASESchWorkAttTowChldProbScl | Recommended | CDE |
| 8 | Child and Adolescent Scale of Environment (CASE) - Community attitude towards child problem scale | The scale relating to there being a problem with other people's attitudes towards the child in his/her community or neighborhood, as part of the Child Adolescent Scale of Environment (CASE) | CASEComtyAttTowChldProbScl | Recommended | CDE |
| 9 | Child and Adolescent Scale of Environment (CASE) - Inadequate lack of assistive device equipment scale | The scale relating to there being an inadequate amount or lack of assistive devices or equipment for the child, as part of the Child Adolescent Scale of Environment (CASE) | CASEInadLackAssistDevEquipScl | Recommended | CDE |
| 10 | Child and Adolescent Scale of Environment (CASE) - Inadequate lack of assistance people home community scale | The scale relating to there being an inadequate amount or lack of assistance from people at home or in the child's community or neighborhood, as part of the Child Adolescent Scale of Environment (CASE) | CASEInadLackAsstHomeComScl | Recommended | CDE |
| 11 | Child and Adolescent Scale of Environment (CASE) - Inadequate lack of assistance people school work scale | The scale relating to there being an inadequate amount or lack or assistance from people at school or work, depending on which is chosen, as part of the Child Adolescent Scale of Environment (CASE) | CASEInadLackAssPplSchoWorkScl | Recommended | CDE |
| 12 | Child and Adolescent Scale of Environment (CASE) - Inadequate lack of transportation scale | The scale relating to there being an inadequate amount or lack of transportation for the child, as part of the Child Adolescent Scale of Environment (CASE) | CASEInadLackTrsptScl | Recommended | CDE |
| 13 | Child and Adolescent Scale of Environment (CASE) - Inadequate lack of program service school scale | The scale relating to there being an inadequate amount or lack of programs or services for the child at school, as part of the Child Adolescent Scale of Environment (CASE) | CASEInadLackProgServSchoolScl | Recommended | CDE |
| 14 | Child and Adolescent Scale of Environment (CASE) - Inadequate lack of program service community scale | The scale relating to there being an inadequate amount or lack of programs or services for the child in his/her community or neighborhood, as part of the Child Adolescent Scale of Environment (CASE) | CASEInadLackProgSrvcComtyScl | Recommended | CDE |
| 15 | Child and Adolescent Scale of Environment (CASE) - Inadequate lack of family finance scale | The scale relating to the child's family having inadequate or a lack of family finances, as part of the Child Adolescent Scale of Environment (CASE) | CASEInadLackFmlyFinScl | Recommended | CDE |
| 16 | Child and Adolescent Scale of Environment (CASE) - Family stress scale | The scale relating to the child having stress from his/her family, as part of the Child Adolescent Scale of Environment (CASE) | CASEFmlyStressScl | Recommended | CDE |
| 17 | Child and Adolescent Scale of Environment (CASE) - Crime violence community neighborhood scale | The scale relating to crime or violence in the community or neighborhood, as part of the Child Adolescent Scale of Environment (CASE) | CASECrmVlCmmNghScl | Recommended | CDE |
| 18 | Child and Adolescent Scale of Environment (CASE) - Government agency policy problem scale | The scale relating to child having problems with government agencies and policies, as part of the Child Adolescent Scale of Environment (CASE) | CASEGovtAgenPolicyProbScl | Recommended | CDE |
| 19 | Child and Adolescent Scale of Environment (CASE) - Inadequate lack of information child diagnosis condition intervention approach scale | The scale relating to there being an inadequate amount or lack of information about the child's diagnosis or condition or interventions or approaches, as part of the Child Adolescent Scale of Environment (CASE) | CASEInaLacInfChiDiaConIntApScl | Recommended | CDE |
| 20 | Child and Adolescent Scale of Environment (CASE) - Problem comment other text | The free-text field describing any other problems or comments about the child, as part of the Child Adolescent Scale of Environment (CASE) | CASEProbCommOTH | Recommended | CDE |
| 21 | Child and Adolescent Scale of Environment (CASE) - Physical social environment support description text | The free-text field identifying the physical or social aspects of the environment or qualities about the services that child receives that are supportive or helpful to child, as part of the Child Adolescent Scale of Environment (CASE) | CASEPhysSocEnvirDescTxt | Recommended | CDE |
Child and Adolescent Scale for Environment Scoring (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Child and Adolescent Scale of Environment (CASE) - Total item level score | The total of the current score based item-level scores, as part of the Child Adolescent Scale of Environment (CASE). | CASETotalItemLevelScore | Recommended | CDE |
| 2 | Child and Adolescent Scale of Environment (CASE) - Total summary score | The total summary score is summing the items responses that are applicable and dividing by maximum possible score and then multiplying this number by 100 to conform to a 100-point scale. | CASETotalSummaryScore | Recommended | CDE |
| 3 | Child and Adolescent Scale of Environment (CASE) - Composite 5-item school score | The total score of 5- item questions for children who are in school only, as part of the Child Adolescent Scale of Environment (CASE). | CASEComposite5ItemSchoolScore | Recommended | CDE |
| 4 | Child and Adolescent Scale of Environment (CASE) - Composite children youth score | The total composite score for applicable for all children and youth, as part of the Child Adolescent Scale of Environment (CASE). | CASECompositeChildYouthScore | Recommended | CDE |
| 5 | Child and Adolescent Scale of Environment (CASE) - Composite 4-item youth transition score | The total score for 4-item questions applicable only to youth in transition to work, as part of the Child Adolescent Scale of Environment (CASE). | CASEComposit4ItemYouthTrnScore | Recommended | CDE |
| 6 | Child and Adolescent Scale of Environment (CASE) - Composite youth transition score | The total of the current score based item-level scores for a subsection, as part of the Child Adolescent Scale of Environment (CASE). | CASECompositeYouthTransScore | Recommended | CDE |
Keywords
