Form Structure: Social Skills Improvement Systems (SSISS) Student Version
| # | 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) Student-Question text (Draft) | Question text , as part of Social Skills Improvement System (SSIS) Student Version | SSISSQuestionTxt | 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) Student-How true type (Draft) | How true type , as part of Social Skills Improvement System (SSIS) Student Version | SSISSHowTrueTyp | Recommended | UDE | 
Problem Behaviors (Appears Up To 28 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) Student-Question text (Draft) | Question text , as part of Social Skills Improvement System (SSIS) Student Version | SSISSQuestionTxt | 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) Student-How true type (Draft) | How true type , as part of Social Skills Improvement System (SSIS) Student Version | SSISSHowTrueTyp | Recommended | UDE | 
SSISS 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 | 
SSISS Summary: Communication (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Social Skills Improvement System (SSIS) Student-Communication sum number (Draft) | Communication sum number , as part of Social Skills Improvement System (SSIS) Student Version | SSISSCommunicationSumNum | Recommended | UDE | 
| 2 | Social Skills Improvement System (SSIS) Student-Communication adjustment value (Draft) | Communication adjustment value , as part of Social Skills Improvement System (SSIS) Student Version | SSISSCommunicationAdjVal | Recommended | UDE | 
| 3 | Social Skills Improvement System (SSIS) Student-Communication raw score (Draft) | Communication raw score , as part of Social Skills Improvement System (SSIS) Student Version | SSISSCommunicationRawScore | 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 | 
SSISS Summary: Cooperation (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Social Skills Improvement System (SSIS) Student-Cooperation sum number (Draft) | Cooperation sum number , as part of Social Skills Improvement System (SSIS) Student Version | SSISSCooperationSumNum | Recommended | UDE | 
| 2 | Social Skills Improvement System (SSIS) Student-Cooperation adjustment value (Draft) | Cooperation adjustment value , as part of Social Skills Improvement System (SSIS) Student Version | SSISSCooperationAdjVal | Recommended | UDE | 
| 3 | Social Skills Improvement System (SSIS) Student-Cooperation raw score (Draft) | Cooperation raw score , as part of Social Skills Improvement System (SSIS) Student Version | SSISSCooperationRawScore | 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 | 
SSIS Summary:Assertion (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Social Skills Improvement System (SSIS) Student-Assertion sum number (Draft) | Assertion sum number , as part of Social Skills Improvement System (SSIS) Student Version | SSISSAssertionSumNum | Recommended | UDE | 
| 2 | Social Skills Improvement System (SSIS) Student-Assertion adjustment value (Draft) | Assertion adjustment value , as part of Social Skills Improvement System (SSIS) Student Version | SSISSAssertionAdjVal | Recommended | UDE | 
| 3 | Social Skills Improvement System (SSIS) Student-Assertion raw score (Draft) | Assertion raw score , as part of Social Skills Improvement System (SSIS) Student Version | SSISSAssertionRawScore | 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 | 
SSISS Summary:Responsibility (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Social Skills Improvement System (SSIS) Student-Responsilibility sum number (Draft) | Responsilibility sum number , as part of Social Skills Improvement System (SSIS) Student Version | SSISSResponsibilitySumNum | Recommended | UDE | 
| 2 | Social Skills Improvement System (SSIS) Student-Responsibility adjustment vale (Draft) | Responsibility adjustment vale , as part of Social Skills Improvement System (SSIS) Student Version | SSISSResponsibilityAdjVal | Recommended | UDE | 
| 3 | Social Skills Improvement System (SSIS) Student-Responsilibility raw score (Draft) | Responsilibility raw score , as part of Social Skills Improvement System (SSIS) Student Version | SSISSResponsibilityRawScore | 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 | 
SSISS Summary: Empathy (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Social Skills Improvement System (SSIS) Student-Empathy sum number (Draft) | Empathy sum number , as part of Social Skills Improvement System (SSIS) Student Version | SSISSEmpathySumNum | Recommended | UDE | 
| 2 | Social Skills Improvement System (SSIS) Student-Empathy adjustment value (Draft) | Empathy adjustment value , as part of Social Skills Improvement System (SSIS) Student Version | SSISSEmpathyAdjVal | Recommended | UDE | 
| 3 | Social Skills Improvement System (SSIS) Student-Empathy raw score (Draft) | Empathy raw score , as part of Social Skills Improvement System (SSIS) Student Version | SSISSEmpathyRawScore | 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 | 
SSISS Summary:Engagement (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Social Skills Improvement System (SSIS) Student-Engagement sum number (Draft) | Engagement sum number , as part of Social Skills Improvement System (SSIS) Student Version | SSISSEngagementSumNum | Recommended | UDE | 
| 2 | Social Skills Improvement System (SSIS) Student-Engagment adjustment value (Draft) | Engagment adjustment value , as part of Social Skills Improvement System (SSIS) Student Version | SSISSEngagementAdjVal | Recommended | UDE | 
| 3 | Social Skills Improvement System (SSIS) Student-Engagement raw score (Draft) | Engagement raw score , as part of Social Skills Improvement System (SSIS) Student Version | SSISSEngagementRawScore | 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 | 
SSISS Summary:Self-Control (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Social Skills Improvement System (SSIS) Student-Self control sum number (Draft) | Self control sum number , as part of Social Skills Improvement System (SSIS) Student Version | SSISSSelfControlSumNum | Recommended | UDE | 
| 2 | Social Skills Improvement System (SSIS) Student-Self-control adjustment value (Draft) | control adjustment value , as part of Social Skills Improvement System (SSIS) Student Version Parent-Self | SSISSSelfControlAdjVal | Recommended | UDE | 
| 3 | Social Skills Improvement System (SSIS) Student-Self control raw score (Draft) | Self control raw score , as part of Social Skills Improvement System (SSIS) Student Version | SSISSSelfControlRawScore | 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 | 
SSISS Summary: Social Skills Scale (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Social Skills Improvement System (SSIS) Student-Social skills raw score (Draft) | Social skills raw score , as part of Social Skills Improvement System (SSIS) Student Version | SSISSSocSkillsRawScore | Recommended | UDE | 
| 2 | Social Skills Improvement System (SSIS) Student-Standard score (Draft) | Standard score , as part of Social Skills Improvement System (SSIS) Student Version | SSISSStandScore | 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 Improvement System (SSIS) Student-Percentile rank value (Draft) | Percentile rank value , as part of Social Skills Improvement System (SSIS) Student Version | SSISSPercentileRnkVal | Recommended | UDE | 
SSISS Summary: Externalizing (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Social Skills Improvement System (SSIS) Student-Externalizaing sum number (Draft) | Externalizaing sum number , as part of Social Skills Improvement System (SSIS) Student Version | SSISSExternalizingSumNum | Recommended | UDE | 
| 2 | Social Skills Improvement System (SSIS) Student-Externalizing adjustment value (Draft) | Externalizing adjustment value , as part of Social Skills Improvement System (SSIS) Student Version | SSISSExternalizingAdjVal | Recommended | UDE | 
| 3 | Social Skills Improvement System (SSIS) Student-Externalizaing raw score (Draft) | Externalizaing raw score , as part of Social Skills Improvement System (SSIS) Student Version | SSISSExternalizingRawScore | 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 | 
SSISS Summary: Bullying (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Social Skills Improvement System (SSIS) Student-Bullying sum number (Draft) | Bullying sum number , as part of Social Skills Improvement System (SSIS) Student Version | SSISSBullyingSumNum | Recommended | UDE | 
| 2 | Social Skills Improvement System (SSIS) Student-Bullying adjustment value (Draft) | Bullying adjustment value , as part of Social Skills Improvement System (SSIS) Student Version | SSISSBullyingAdjVal | Recommended | UDE | 
| 3 | Social Skills Improvement System (SSIS) Student-Bullying raw score (Draft) | Bullying raw score , as part of Social Skills Improvement System (SSIS) Student Version | SSISSBullyingRawScore | 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 | 
SSISS Summary: Hyperactivity/Inattention (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Social Skills Improvement System (SSIS) Student-Hyperactivity inattention sum number (Draft) | Hyperactivity inattention sum number , as part of Social Skills Improvement System (SSIS) Student Version | SSISSHyperInattSumNum | Recommended | UDE | 
| 2 | Social Skills Improvement System (SSIS) Student-Hyperactivity/inattention adjustment value (Draft) | Hyperactivity/inattention adjustment value , as part of Social Skills Improvement System (SSIS) Student Version | SSISSHyperInattAdjVal | Recommended | UDE | 
| 3 | Social Skills Improvement System (SSIS) Student-Hyperactivity inattention raw score (Draft) | Hyperactivity inattention raw score , as part of Social Skills Improvement System (SSIS) Student Version | SSISSHyperInattRawScore | 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 | 
SSISS Summary: Internalizing (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Social Skills Improvement System (SSIS) Student-Internalizing sum number (Draft) | Internalizing sum number , as part of Social Skills Improvement System (SSIS) Student Version | SSISSInternalizingSumNum | Recommended | UDE | 
| 2 | Social Skills Improvement System (SSIS) Student-Internalizing adjustment value (Draft) | Internalizing adjustment value , as part of Social Skills Improvement System (SSIS) Student Version | SSISSInternalizingAdjVal | Recommended | UDE | 
| 3 | Social Skills Improvement System (SSIS) Student-Internalizing raw score (Draft) | Internalizing raw score , as part of Social Skills Improvement System (SSIS) Student Version | SSISSInternalizingRawScore | 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 | 
SSISS Summary: Problem Behaviors Scale (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Social Skills Improvement System (SSIS) Student-Problem behaviors sum number (Draft) | Problem behaviors sum number , as part of Social Skills Improvement System (SSIS) Student Version | SSISSProbBehaviorsSumNum | Recommended | UDE | 
| 2 | Social Skills Improvement System (SSIS) Student-Problem behaviors adjustment value (Draft) | Problem behaviors adjustment value , as part of Social Skills Improvement System (SSIS) Student Version | SSISSProbBehaviorsAdjVal | Recommended | UDE | 
| 3 | Social Skills Improvement System (SSIS) Student-Problem behaviors raw score (Draft) | Problem behaviors raw score , as part of Social Skills Improvement System (SSIS) Student Version | SSISSProbBehaviorsRawScore | Recommended | UDE | 
| 4 | Social Skills Improvement System (SSIS) Student-Standard score (Draft) | Standard score , as part of Social Skills Improvement System (SSIS) Student Version | SSISSStandScore | 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 Improvement System (SSIS) Student-Percentile rank value (Draft) | Percentile rank value , as part of Social Skills Improvement System (SSIS) Student Version | SSISSPercentileRnkVal | Recommended | UDE | 
Analysis of Social Behaviors (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Social Skills Improvement System (SSIS) Student-Social skills strengths text (Draft) | Social skills strengths text , as part of Social Skills Improvement System (SSIS) Student Version | SSISSSocSkillsStrengthsTxt | Recommended | UDE | 
| 2 | Social Skills Improvement System (SSIS) Student-Social skills performance deficits text (Draft) | Social skills performance deficits text , as part of Social Skills Improvement System (SSIS) Student Version | SSISSSockSkillsPerfDeficitTxt | Recommended | UDE | 
| 3 | Social Skills Improvement System (SSIS) Student-Social skills acquisition deficits text | Social skills acquisition deficits text , as part of Social Skills Improvement System (SSIS) Student Version | SSISSSocSkillsAcqDeficitTxt | Recommended | UDE | 
| 4 | Social Skills Improvement System (SSIS) Student-Competing problem behaviors text (Draft) | Competing problem behaviors text , as part of Social Skills Improvement System (SSIS) Student Version | SSISSCompetingProbBehaviorTxt | Recommended | UDE | 
Additional Assessment Information (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Social Skills Improvement System (SSIS) Student-Summary text (Draft) | Summary text , as part of Social Skills Improvement System (SSIS) Student Version | SSISSSummaryTxt | Recommended | UDE | 
| 2 | Social Skills Improvement System (SSIS) Student-Assessment date (Draft) | Assessment date , as part of Social Skills Improvement System (SSIS) Student Version | SSISSAssessmentDate | Recommended | UDE | 
| 3 | Social Skills Improvement System (SSIS) Student-Additional assessment information type (Draft) | Additional assessment information type , as part of Social Skills Improvement System (SSIS) Student Version | SSISSAdditionalAssessInfoTyp | Recommended | UDE | 
Intervention Planning Notes (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Social Skills Improvement System (SSIS) Student-Intervention planning notes type (Draft) | Intervention planning notes type , as part of Social Skills Improvement System (SSIS) Student Version | SSISSIntPlanningNotesTyp | Recommended | UDE | 
| 2 | Social Skills Improvement System (SSIS) Student-Summary text (Draft) | Summary text , as part of Social Skills Improvement System (SSIS) Student Version | SSISSSummaryTxt | Recommended | UDE | 
 
								






