Form Structure: Tests for Auditory Processing Disorders for Children (SCAN-3:C)-Diagnostic Tests
This form structure is an organized set of data definitions for a copyrighted form
Resource:
FITBIR
Title:
Tests for Auditory Processing Disorders for Children (SCAN-3:C)-Diagnostic Tests
Short Name:
SCAN3CDiagnosticTests
Description:
SCAN3-C is designed to identify auditory processing disorders in children. Diagnostic tests include Filtered Words (FW), Auditory Figure-Ground + 8 dB (AFG +8), Competing Words-Directed Ear (CW-DE) and Competing Sentences (CS). Keith, R. W. (2009). SCAN-3 for Children: Test for Auditory Processing Disorders. Pearson. Copyright 2009, 2000 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:
2016-08-25
Owner:
Number of Data Elements:
78
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 |
Filtered Words (Appears Up To 40 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 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Filtered Words word text | Word text for Filtered Words, as part of SCAN-3 for children (SCAN-3C) | SCAN3CFWWordTxt | Recommended | CDE |
| 3 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Filtered Words response text | Response text for Filtered Words, as part of SCAN-3 for children (SCAN-3C) | SCAN3CFWRespnsTxt | Recommended | CDE |
| 4 | Tests for Auditory Processing Disorders (SCAN, SCAN-3C, SCAN3-A) - Correctness status | Status regarding whether the words are repeated correctly, as part of SCAN-3 for children (SCAN-3C), A Test for Auditory Processing Disorders in Adolescents and Adults (SCAN3-A) and Test for Auditory Processing Disorders in Children-revised (SCAN-C) | SCANCorrectnessStat | Recommended | CDE |
Filtered Words-Scoring (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Filtered Words right ear score | Score calculated as the count of correct responses to test items 1 to 20 of Filtered Words for the right ear, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CFWREScore | Recommended | CDE |
| 2 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Filtered Words left ear score | Score calculated as the count of correct responses to test items 21 to 40 of Filtered Words for the left ear, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CFWLEScore | Recommended | CDE |
| 3 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Filtered Words total raw score | FW total score, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CFWTtlRawScore | Recommended | CDE |
Auditory Figure-Ground +8 dB (Appears Up To 40 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 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Auditory Figure - Ground +8 dB word text | Word text for Auditory Figure-Ground +8 dB, as part of SCAN-3 for children (SCAN-3C) | SCAN3CAFG8WordTxt | Recommended | CDE |
| 3 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Auditory Figure - Ground + 8 dB response text | Response text for Auditory Figure-Ground +8 dB, as part of SCAN-3 for children (SCAN-3C) | SCAN3CAFG8RRespnsTxt | Recommended | CDE |
| 4 | Tests for Auditory Processing Disorders (SCAN, SCAN-3C, SCAN3-A) - Correctness status | Status regarding whether the words are repeated correctly, as part of SCAN-3 for children (SCAN-3C), A Test for Auditory Processing Disorders in Adolescents and Adults (SCAN3-A) and Test for Auditory Processing Disorders in Children-revised (SCAN-C) | SCANCorrectnessStat | Recommended | CDE |
Auditory Figure-Ground +8 dB-Scoring (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Auditory Figure - Ground + 8 dB right ear score | Score calculated as the count of correct responses to test items 1 to 20 of Auditory Figure-Ground +8 dB for the right ear, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CAFG8REScore | Recommended | CDE |
| 2 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Auditory Figure - Ground + 8 dB left ear score | Score calculated as the count of correct responses to test items 21 to 40 of Auditory Figure-Ground +8 dB for the left ear, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CAFG8LEScore | Recommended | CDE |
| 3 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Auditory Figure - Ground + 8 dB total raw score | AFG+8 total score, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CAFG8TtlRawScore | Recommended | CDE |
Competing Words-Directed Ear-right ear (Appears Up To 30 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 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Right Ear word text | Word text for Competing Words-Directed Right Ear, as part of SCAN-3 for children (SCAN-3C) | SCAN3CCWDREWordTxt | Recommended | CDE |
| 3 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Right Ear response text | Response text for Competing Words-Directed Right Ear, as part of SCAN-3 for children (SCAN-3C) | SCAN3CCWDRERespnsTxt | Recommended | CDE |
| 4 | Tests for Auditory Processing Disorders (SCAN, SCAN-3C, SCAN3-A) - Correctness status | Status regarding whether the words are repeated correctly, as part of SCAN-3 for children (SCAN-3C), A Test for Auditory Processing Disorders in Adolescents and Adults (SCAN3-A) and Test for Auditory Processing Disorders in Children-revised (SCAN-C) | SCANCorrectnessStat | Recommended | CDE |
Competing Words-Directed Ear-right ear-Scoring (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Right Ear right ear score | Score calculated as the count of correct responses to test items 1 to 15 of Competing Words-Directed Right Ear for the right ear, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCWDREREScore | Recommended | CDE |
| 2 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Right Ear left ear score | Score calculated as the count of correct responses to test items 16 to 30 of Competing Words-Directed Right Ear for the left ear, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCWDRELEScore | Recommended | CDE |
Competing Words-Directed Ear-left ear (Appears Up To 30 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 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Left Ear word text | Word text for Competing Words-Directed Left Ear, as part of SCAN-3 for children (SCAN-3C) | SCAN3CCWDLEWordTxt | Recommended | CDE |
| 3 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Left Ear response text | Response text for Competing Words-Directed Left Ear, as part of SCAN-3 for children (SCAN-3C) | SCAN3CCWDLERespnsTxt | Recommended | CDE |
| 4 | Tests for Auditory Processing Disorders (SCAN, SCAN-3C, SCAN3-A) - Correctness status | Status regarding whether the words are repeated correctly, as part of SCAN-3 for children (SCAN-3C), A Test for Auditory Processing Disorders in Adolescents and Adults (SCAN3-A) and Test for Auditory Processing Disorders in Children-revised (SCAN-C) | SCANCorrectnessStat | Recommended | CDE |
Competing Words-Directed Ear-left ear-Scoring (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Left Ear right ear score | Score calculated as the count of correct responses to test items 1 to 15 of Competing Words-Directed Left Ear for the left ear, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCWDLELEScore | Recommended | CDE |
| 2 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Right Ear right ear score | Score calculated as the count of correct responses to test items 16 to 30 of Competing Words-Directed Left Ear for the right ear, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCWDLEREScore | Recommended | CDE |
Competing Words-Directed Ear-Scoring (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Ear right ear total raw score | RE total score for Competing Words-Directed Ear, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCWDERETtlRawScore | Recommended | CDE |
| 2 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Ear left ear total raw score | LE total score for Competing Words-Directed Ear, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCWDELETtlRawScore | Recommended | CDE |
| 3 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Words - Directed Ear total raw score | CW-DE total score for Competing Words-Directed Ear, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCWDETtlRawScore | Recommended | CDE |
Competing Sentences-Item 1 (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences word text | Competing Sentences word text, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSWordTxt | Recommended | CDE |
| 2 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences response text | Competing Sentences response text, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSRespnsTxt | Recommended | CDE |
| 3 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences words correct 4 count | Count of correct words of Competing Sentences with the maximum of 4, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSWordsCorrect4Ct | Recommended | CDE |
Competing Sentences-Items 2-6 (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 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences word text | Competing Sentences word text, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSWordTxt | Recommended | CDE |
| 3 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences response text | Competing Sentences response text, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSRespnsTxt | Recommended | CDE |
| 4 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences words correct 3 count | Count of correct words of Competing Sentences with the maximum of 3, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSWordsCorrect3Ct | Recommended | CDE |
Competing Sentences-Item 7 (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences word text | Competing Sentences word text, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSWordTxt | Recommended | CDE |
| 2 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences response text | Competing Sentences response text, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSRespnsTxt | Recommended | CDE |
| 3 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences words correct 5 count | Count of correct words of Competing Sentences with the maximum of 5, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSWordsCorrect5Ct | Recommended | CDE |
Competing Sentences-Item 8 (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences word text | Competing Sentences word text, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSWordTxt | Recommended | CDE |
| 2 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences response text | Competing Sentences response text, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSRespnsTxt | Recommended | CDE |
| 3 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences words correct 3 count | Count of correct words of Competing Sentences with the maximum of 3, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSWordsCorrect3Ct | Recommended | CDE |
Competing Sentences-Items 9-11 (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 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences word text | Competing Sentences word text, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSWordTxt | Recommended | CDE |
| 3 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences response text | Competing Sentences response text, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSRespnsTxt | Recommended | CDE |
| 4 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences words correct 4 count | Count of correct words of Competing Sentences with the maximum of 4, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSWordsCorrect4Ct | Recommended | CDE |
Competing Sentences-Items 12-16 (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 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences word text | Competing Sentences word text, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSWordTxt | Recommended | CDE |
| 3 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences response text | Competing Sentences response text, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSRespnsTxt | Recommended | CDE |
| 4 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences words correct 3 count | Count of correct words of Competing Sentences with the maximum of 3, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSWordsCorrect3Ct | Recommended | CDE |
Competing Sentences-Item 17 (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences word text | Competing Sentences word text, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSWordTxt | Recommended | CDE |
| 2 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences response text | Competing Sentences response text, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSRespnsTxt | Recommended | CDE |
| 3 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences words correct 5 count | Count of correct words of Competing Sentences with the maximum of 5, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSWordsCorrect5Ct | Recommended | CDE |
Competing Sentences-Item 18 (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences word text | Competing Sentences word text, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSWordTxt | Recommended | CDE |
| 2 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences response text | Competing Sentences response text, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSRespnsTxt | Recommended | CDE |
| 3 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences words correct 3 count | Count of correct words of Competing Sentences with the maximum of 3, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSWordsCorrect3Ct | Recommended | CDE |
Competing Sentences-Items 19-20 (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 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences word text | Competing Sentences word text, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSWordTxt | Recommended | CDE |
| 3 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences response text | Competing Sentences response text, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSRespnsTxt | Recommended | CDE |
| 4 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences words correct 4 count | Count of correct words of Competing Sentences with the maximum of 4, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSWordsCorrect4Ct | Recommended | CDE |
Competing Sentences-Scoring (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences right ear total raw score | Raw score calculated as the Raw score calculated as the sum of words correct for items 1 to 10 of Completing Sentences, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSRETtlRawScore | Recommended | CDE |
| 2 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences left ear total raw score | Raw score calculated as the sum of words correct for items 11 to 20 of Completing Sentences, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSLETtlRawScore | Recommended | CDE |
| 3 | SCAN-3:C Tests for Auditory Processing Disorders for Children - Competing Sentences total raw score | CS total score, as part of the SCAN-3 for children (SCAN-3C) | SCAN3CCSTtlRawScore | Recommended | CDE |
Keywords
