Form Structure: Test for Auditory Processing Disorders in Children-Revised (SCAN-C) screening
This form structure is an organized set of data definitions for a copyrighted form
Resource:
FITBIR
Title:
Test for Auditory Processing Disorders in Children-Revised (SCAN-C) screening
Short Name:
SCANCScreening
Description:
SCAN-C is used to detect auditory processing disorders in children. Keith, R. W. (2000). Development and standardization of SCAN-C test for auditory processing disorders in children. JOURNAL-AMERICAN ACADEMY OF AUDIOLOGY, 11(8), 438-445. Robert W. Keith; Copyright 2000 NCS Pearson, Inc. http://www.pearsonclinical.com
Disease:
General (For all diseases)
Traumatic Brain Injury
Organization:
FITBIR
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-11-16
Owner:
Number of Data Elements:
19
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 |
Screening (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
A Test for Auditory Processing Disorders-English dominant indicator
(Draft) |
Indicates whether English is the subject's dominant language, as part of A Test for Auditory Processing Disorders in Adolescents and Adults (SCAN-A) and Test for Auditory Processing Disorders in Children-revised (SCAN-C) | SCANEngDominantInd | Recommended | UDE |
| 2 |
A Test for Auditory Processing Disorders- Behavioral observations text
(Draft) |
Description of behavioral observations, as part of A Test for Auditory Processing Disorders in Adolescents and Adults (SCAN-A) and Test for Auditory Processing Disorders in Children-revised (SCAN-C) | SCANBehvrObsTxt | Recommended | UDE |
Pure tone results (Appears Up To 2 Times)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | NIH Toolbox Sensation Domain Audition Measure Hearing Threshold Test - Ear type | Type of ear being tested, as part of the NIH Toolbox Sensation Domain Audition Measure Hearing Threshold Test | NIHTBHTTEarTyp | Recommended | CDE |
| 2 |
A Test for Auditory Processing Disorders-Pure tone frequency
(Draft) |
Pure tone frequency in Hz, as part of A Test for Auditory Processing Disorders in Adolescents and Adults (SCAN-A) and Test for Auditory Processing Disorders in Children-revised (SCAN-C) | SCANPureToneFreq | Recommended | UDE |
Keywords
