Form Structure: Social Skills Improvement Systems (SSISP) Parent Version
This form structure is an organized set of data definitions for a copyrighted form
Title:
Social Skills Improvement Systems (SSISP) Parent Version
Short Name:
SSISPParent
Description:
"The SSISP (Social Skills Improvement System) Rating Scales enables targeted assessment of individuals and small groups to help evaluate social skills, problem behaviors, and academic competence. Teacher, parent and student forms help provide a comprehensive picture across school, home, and community settings.Gresham, F., & Elliott, S. N. (2007). Social Skills Improvement System (SSISP) Rating Scales. San Antonio, TX: Copyright Pearson Education Inc.;http://www.pearsonclinical.com/"
Disease:
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:
2016-12-06
Owner:
Number of Data Elements:
97
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 |
Social Skills (Appears Up To 46 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 |
Social Skills Improvement System (SSIS)-Question text
(Draft) |
Question text , as part of Social Skills Improvement System (SSIS) | SSISPQuestionTxt | Recommended | UDE |
| 3 | Test item response text | The test (or assessment) item response text representing the answer for the items/questions of each test/assessment/questionnaire being asked. | TestItemRespTxt | Recommended | CDE |
| 4 |
Social Skills Improvement System (SSIS)-How often type
(Draft) |
How often type , as part of Social Skills Improvement System (SSIS) | SSISPHowOftenTyp | Recommended | UDE |
| 5 |
Social Skills Improvement System (SSIS)-How important type
(Draft) |
How important type , as part of Social Skills Improvement System (SSIS) | SSISPHowImportantTyp | Recommended | UDE |
Problem Behaviors (Appears Up To 33 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 |
Social Skills Improvement System (SSIS)-Question text
(Draft) |
Question text , as part of Social Skills Improvement System (SSIS) | SSISPQuestionTxt | Recommended | UDE |
| 3 | Test item response text | The test (or assessment) item response text representing the answer for the items/questions of each test/assessment/questionnaire being asked. | TestItemRespTxt | Recommended | CDE |
| 4 |
Social Skills Improvement System (SSIS)-How often type
(Draft) |
How often type , as part of Social Skills Improvement System (SSIS) | SSISPHowOftenTyp | Recommended | UDE |
SSISP Summary: Norm Group and F Index (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Improvement System (SSIS)-Age interval type
(Draft) |
Age interval type , as part of Social Skills Improvement System (SSIS) | SSISAgeIntvTyp | Recommended | UDE |
| 2 |
Social Skills Improvement System(SSIS)-Sex norm group type
(Draft) |
Sex norm group type , as part of Social Skills Improvement System(SSIS) | SSISSexNormGroupTyp | Recommended | UDE |
| 3 |
Social Skills Adjustment System (SSIS)-Confidence interval type
(Draft) |
Confidence interval type , as part of Social Skills Adjustment System (SSIS) | SSISConfInterTyp | Recommended | UDE |
| 4 |
Social Skills Adjustment System (SSIS)-F index type
(Draft) |
F index type , as part of Social Skills Adjustment System (SSIS) | SSISFIndexTyp | Recommended | UDE |
SSISP Summary: Communication (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Adjustment System (SSIS)-Communication sum number
(Draft) |
Communication sum number , as part of Social Skills Adjustment System (SSIS) | SSISPCommunicationSumNum | Recommended | UDE |
| 2 |
Social Skills Improvement System (SSIS)-Communication adjustment value
(Draft) |
Communication adjustment value , as part of Social Skills Improvement System (SSIS) | SSISPCommunicationAdjVal | Recommended | UDE |
| 3 |
Social Skills Adjustment System (SSIS)-Communication raw score
(Draft) |
Communication raw score , as part of Social Skills Adjustment System (SSIS) | SSISPCommunicationRawScore | Recommended | UDE |
| 4 |
Social Skills Adjustment System (SSIS)-Behavior level type
(Draft) |
Behavior level type , as part of Social Skills Adjustment System (SSIS) | SSISBehaviorLevelTyp | Recommended | UDE |
SSISP Summary: Cooperation (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Adjustment System (SSIS)-Cooperation sum number
(Draft) |
Cooperation sum number , as part of Social Skills Adjustment System (SSIS) | SSISPCooperationSumNum | Recommended | UDE |
| 2 |
Social Skills Improvement System (SSIS)-Cooperation adjustment value
(Draft) |
Cooperation adjustment value , as part of Social Skills Improvement System (SSIS) | SSISPCooperationAdjVal | Recommended | UDE |
| 3 |
Social Skills Adjustment System (SSIS)-Cooperation raw score
(Draft) |
Cooperation raw score , as part of Social Skills Adjustment System (SSIS) | SSISPCooperationRawScore | Recommended | UDE |
| 4 |
Social Skills Adjustment System (SSIS)-Behavior level type
(Draft) |
Behavior level type , as part of Social Skills Adjustment System (SSIS) | SSISBehaviorLevelTyp | Recommended | UDE |
SSISP Summary:Assertion (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Adjustment System (SSIS)-Assertion sum number
(Draft) |
Assertion sum number , as part of Social Skills Adjustment System (SSIS) | SSISPAssertionSumNum | Recommended | UDE |
| 2 |
Social Skills Improvement System (SSIS)-Assertion adjustment value
(Draft) |
Assertion adjustment value , as part of Social Skills Improvement System (SSIS) | SSISPAssertionAdjVal | Recommended | UDE |
| 3 |
Social Skills Adjustment System (SSIS)-Assertion raw score
(Draft) |
Assertion raw score , as part of Social Skills Adjustment System (SSIS) | SSISPAssertionRawScore | Recommended | UDE |
| 4 |
Social Skills Adjustment System (SSIS)-Behavior level type
(Draft) |
Behavior level type , as part of Social Skills Adjustment System (SSIS) | SSISBehaviorLevelTyp | Recommended | UDE |
SSISP Summary:Responsibility (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Adjustment System (SSIS)-Responsilibility sum number
(Draft) |
Responsilibility sum number , as part of Social Skills Adjustment System (SSIS) | SSISPResponsibilitySumNum | Recommended | UDE |
| 2 |
Social Skills Improvement System (SSIS)-Responsibility adjustment vale
(Draft) |
Responsibility adjustment vale , as part of Social Skills Improvement System (SSIS) | SSISPResponsibilityAdjVal | Recommended | UDE |
| 3 |
Social Skills Adjustment System (SSIS)-Responsilibility raw score
(Draft) |
Responsilibility raw score , as part of Social Skills Adjustment System (SSIS) | SSISPResponsibilityRawScore | Recommended | UDE |
| 4 |
Social Skills Adjustment System (SSIS)-Behavior level type
(Draft) |
Behavior level type , as part of Social Skills Adjustment System (SSIS) | SSISBehaviorLevelTyp | Recommended | UDE |
SSISP Summary: Empathy (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Adjustment System (SSIS)-Empathy sum number
(Draft) |
Empathy sum number , as part of Social Skills Adjustment System (SSIS) | SSISPEmpathySumNum | Recommended | UDE |
| 2 |
Social Skills Improvement System (SSIS)-Empathy adjustment value
(Draft) |
Empathy adjustment value , as part of Social Skills Improvement System (SSIS) | SSISPEmpathyAdjVal | Recommended | UDE |
| 3 |
Social Skills Adjustment System (SSIS)-Empathy raw score
(Draft) |
Empathy raw score , as part of Social Skills Adjustment System (SSIS) | SSISPEmpathyRawScore | Recommended | UDE |
| 4 |
Social Skills Adjustment System (SSIS)-Behavior level type
(Draft) |
Behavior level type , as part of Social Skills Adjustment System (SSIS) | SSISBehaviorLevelTyp | Recommended | UDE |
SSISP Summary:Engagement (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Adjustment System (SSIS)-Engagement sum number
(Draft) |
Engagement sum number , as part of Social Skills Adjustment System (SSIS) | SSISPEngagementSumNum | Recommended | UDE |
| 2 |
Social Skills Improvement System (SSIS)-Engagment adjustment value
(Draft) |
Engagment adjustment value , as part of Social Skills Improvement System (SSIS) | SSISPEngagementAdjVal | Recommended | UDE |
| 3 |
Social Skills Adjustment System (SSIS)-Engagement raw score
(Draft) |
Engagement raw score , as part of Social Skills Adjustment System (SSIS) | SSISPEngagementRawScore | Recommended | UDE |
| 4 |
Social Skills Adjustment System (SSIS)-Behavior level type
(Draft) |
Behavior level type , as part of Social Skills Adjustment System (SSIS) | SSISBehaviorLevelTyp | Recommended | UDE |
SSISP Summary:Self-Control (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Adjustment System (SSIS)-Self control sum number
(Draft) |
Self control sum number , as part of Social Skills Adjustment System (SSIS) | SSISPSelfControlSumNum | Recommended | UDE |
| 2 |
Social Skills Improvement System (SSIS)-Self-control adjustment value
(Draft) |
control adjustment value , as part of Social Skills Improvement System (SSIS)-Self | SSISPSelfControlAdjVal | Recommended | UDE |
| 3 |
Social Skills Adjustment System (SSIS)-Self control raw score
(Draft) |
Self control raw score , as part of Social Skills Adjustment System (SSIS) | SSISPSelfControlRawScore | Recommended | UDE |
| 4 |
Social Skills Adjustment System (SSIS)-Behavior level type
(Draft) |
Behavior level type , as part of Social Skills Adjustment System (SSIS) | SSISBehaviorLevelTyp | Recommended | UDE |
SSISP Summary: Social Skills Scale (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Improvement System (SSIS)-Social skills raw score
(Draft) |
Social skills raw score , as part of Social Skills Improvement System (SSIS) | SSISPSocSkillsRawScore | Recommended | UDE |
| 2 |
Social Skills Adjustment System (SSIS)-Standard score
(Draft) |
Standard score , as part of Social Skills Adjustment System (SSIS) | SSISPStandScore | Recommended | UDE |
| 3 |
Social Skills Adjustment System (SSIS)-Confidence interval type
(Draft) |
Confidence interval type , as part of Social Skills Adjustment System (SSIS) | SSISConfInterTyp | Recommended | UDE |
| 4 |
Social Skills Adjustment System (SSIS)-Percentile rank value
(Draft) |
Percentile rank value , as part of Social Skills Adjustment System (SSIS) | SSISPPercentileRnkVal | Recommended | UDE |
SSISP Summary: Externalizing (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Adjustment System (SSIS)-Externalizaing sum number
(Draft) |
Externalizaing sum number , as part of Social Skills Adjustment System (SSIS) | SSISPExternalizingSumNum | Recommended | UDE |
| 2 |
Social Skills Improvement System (SSIS)-Externalizing adjustment value
(Draft) |
Externalizing adjustment value , as part of Social Skills Improvement System (SSIS) | SSISPExternalizingAdjVal | Recommended | UDE |
| 3 |
Social Skills Adjustment System (SSIS)-Externalizaing raw score
(Draft) |
Externalizaing raw score , as part of Social Skills Adjustment System (SSIS) | SSISPExternalizingRawScore | Recommended | UDE |
| 4 |
Social Skills Adjustment System (SSIS)-Behavior level type
(Draft) |
Behavior level type , as part of Social Skills Adjustment System (SSIS) | SSISBehaviorLevelTyp | Recommended | UDE |
SSISP Summary: Bullying (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Adjustment System (SSIS)-Bullying sum number
(Draft) |
Bullying sum number , as part of Social Skills Adjustment System (SSIS) | SSISPBullyingSumNum | Recommended | UDE |
| 2 |
Social Skills Improvement System (SSIS)-Bullying adjustment value
(Draft) |
Bullying adjustment value , as part of Social Skills Improvement System (SSIS) | SSISPBullyingAdjVal | Recommended | UDE |
| 3 |
Social Skills Adjustment System (SSIS)-Bullying raw score
(Draft) |
Bullying raw score , as part of Social Skills Adjustment System (SSIS) | SSISPBullyingRawScore | Recommended | UDE |
| 4 |
Social Skills Adjustment System (SSIS)-Behavior level type
(Draft) |
Behavior level type , as part of Social Skills Adjustment System (SSIS) | SSISBehaviorLevelTyp | Recommended | UDE |
SSISP Summary: Hyperactivity/Inattention (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Adjustment System (SSIS)-Hyperactivity inattention sum number
(Draft) |
Hyperactivity inattention sum number , as part of Social Skills Adjustment System (SSIS) | SSISPHyperInattSumNum | Recommended | UDE |
| 2 |
Social Skills Improvement System (SSIS)-Hyperactivity/inattention adjustment value
(Draft) |
Hyperactivity/inattention adjustment value , as part of Social Skills Improvement System (SSIS) | SSISPHyperInattAdjVal | Recommended | UDE |
| 3 |
Social Skills Adjustment System (SSIS)-Hyperactivity inattention raw score
(Draft) |
Hyperactivity inattention raw score , as part of Social Skills Adjustment System (SSIS) | SSISPHyperInattRawScore | Recommended | UDE |
| 4 |
Social Skills Adjustment System (SSIS)-Behavior level type
(Draft) |
Behavior level type , as part of Social Skills Adjustment System (SSIS) | SSISBehaviorLevelTyp | Recommended | UDE |
SSISP Summary: Internalizing (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Adjustment System (SSIS)-Internalizing sum number
(Draft) |
Internalizing sum number , as part of Social Skills Adjustment System (SSIS) | SSISPInternalizingSumNum | Recommended | UDE |
| 2 |
Social Skills Improvement System (SSIS)-Internalizing adjustment value
(Draft) |
Internalizing adjustment value , as part of Social Skills Improvement System (SSIS) | SSISPInternalizingAdjVal | Recommended | UDE |
| 3 |
Social Skills Adjustment System (SSIS)-Internalizing raw score
(Draft) |
Internalizing raw score , as part of Social Skills Adjustment System (SSIS) | SSISPInternalizingRawScore | Recommended | UDE |
| 4 |
Social Skills Adjustment System (SSIS)-Behavior level type
(Draft) |
Behavior level type , as part of Social Skills Adjustment System (SSIS) | SSISBehaviorLevelTyp | Recommended | UDE |
SSISP Summary: Part A Reverse Score (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Adjustment System (SSIS)-Autism spectrum part A raw score
(Draft) |
Autism spectrum part A raw score , as part of Social Skills Adjustment System (SSIS) | SSISPAutSpecPartARawScore | Recommended | UDE |
| 2 |
Social Skills Improvement System (SSIS)-Autism spectrum part A reverse score
(Draft) |
Autism spectrum part A reverse score , as part of Social Skills Improvement System (SSIS) | SSISPAutSpecPartARevScore | Recommended | UDE |
SSISP Summary: Autism Spectrum (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Improvement System (SSIS)-Autism spectrum part A reverse score
(Draft) |
Autism spectrum part A reverse score , as part of Social Skills Improvement System (SSIS) | SSISPAutSpecPartARevScore | Recommended | UDE |
| 2 |
Social Skills Adjustment System (SSIS)-Autism spectrum part B raw score
(Draft) |
Autism spectrum part B raw score , as part of Social Skills Adjustment System (SSIS) | SSISPAutSpecPartBRawScore | Recommended | UDE |
| 3 |
Social Skills Improvement System (SSIS)-Autism spectrum raw score
(Draft) |
Autism spectrum raw score , as part of Social Skills Improvement System (SSIS) | SSISPAutSpecRawScore | Recommended | UDE |
| 4 |
Social Skills Adjustment System (SSIS)-Behavior level type
(Draft) |
Behavior level type , as part of Social Skills Adjustment System (SSIS) | SSISBehaviorLevelTyp | Recommended | UDE |
SSISP Summary: Problem Behaviors Scale (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Adjustment System (SSIS)-Problem behaviors sum number
(Draft) |
Problem behaviors sum number , as part of Social Skills Adjustment System (SSIS) | SSISPProbBehaviorsSumNum | Recommended | UDE |
| 2 |
Social Skills Improvement System (SSIS)-Problem behaviors adjustment value
(Draft) |
Problem behaviors adjustment value , as part of Social Skills Improvement System (SSIS) | SSISPProbBehaviorsAdjVal | Recommended | UDE |
| 3 |
Social Skills Adjustment System (SSIS)-Problem behaviors raw score
(Draft) |
Problem behaviors raw score , as part of Social Skills Adjustment System (SSIS) | SSISPProbBehaviorsRawScore | Recommended | UDE |
| 4 |
Social Skills Adjustment System (SSIS)-Standard score
(Draft) |
Standard score , as part of Social Skills Adjustment System (SSIS) | SSISPStandScore | Recommended | UDE |
| 5 |
Social Skills Adjustment System (SSIS)-Confidence interval type
(Draft) |
Confidence interval type , as part of Social Skills Adjustment System (SSIS) | SSISConfInterTyp | Recommended | UDE |
| 6 |
Social Skills Adjustment System (SSIS)-Percentile rank value
(Draft) |
Percentile rank value , as part of Social Skills Adjustment System (SSIS) | SSISPPercentileRnkVal | Recommended | UDE |
Analysis of Social Behaviors (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Improvement System (SSIS)-Social skills strengths text
(Draft) |
Social skills strengths text , as part of Social Skills Improvement System (SSIS) | SSISPSocSkillsStrengthsTxt | Recommended | UDE |
| 2 |
Social Skills Improvement System (SSIS)-Social skills performance deficits text
(Draft) |
Social skills performance deficits text , as part of Social Skills Improvement System (SSIS) | SSISPSockSkillsPerfDeficitTxt | Recommended | UDE |
| 3 | Social Skills Improvement System (SSIS)-Social skills acquisition deficits text | Social skills acquisition deficits text , as part of Social Skills Improvement System (SSIS) | SSISPSocSkillsAcqDeficitTxt | Recommended | UDE |
| 4 |
Social SkillS Improvement System (SSIS)-Competing problem behaviors text
(Draft) |
Competing problem behaviors text , as part of Social SkillS Improvement System (SSIS) | SSISPCompetingProbBehaviorTxt | Recommended | UDE |
Additional Assessment Information (Appears Up To 4 Times)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Improvement System (SSIS)-Additional assessment information type
(Draft) |
Additional assessment information type , as part of Social Skills Improvement System (SSIS) | SSISPAdditionalAssessInfoTyp | Recommended | UDE |
| 2 |
Social Skills Improvement System (SSIS)-Assessment date
(Draft) |
Assessment date , as part of Social Skills Improvement System (SSIS) | SSISPAssessmentDate | Recommended | UDE |
| 3 |
Social Skills Improvement System (SSIS)-Summary text
(Draft) |
Summary text , as part of Social Skills Improvement System (SSIS) | SSISPSummaryTxt | Recommended | UDE |
Intervention Planning Notes (Appears Up To 10 Times)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
Social Skills Improvement System (SSIS)-Intervention planning notes type
(Draft) |
Intervention planning notes type , as part of Social Skills Improvement System (SSIS) | SSISPIntPlanningNotesTyp | Recommended | UDE |
| 2 |
Social Skills Improvement System (SSIS)-Summary text
(Draft) |
Summary text , as part of Social Skills Improvement System (SSIS) | SSISPSummaryTxt | Recommended | UDE |
Keywords
